Preamble

The House met at half-past
Two o'clock

PRAYERS

[Mr. SPEAKER in the Chair]

DEATH OF SIR WINSTON CHURCHILL

Message of Condolence

Mr. Speaker: I have to acquaint the House that I have received a letter from the President of the Chamber of Representatives of Uruguay expressing, in accordance with a Resolution of the Chamber, sympathy with the British people on the death of Sir Winston Churchill. I will have the text placed in the Library where it can be seen by hon. Members.

Oral Answers to Questions — MINISTRY OF AVIATION

Inclusive Tour Arrangements

Mr. Shepherd: asked the Minister of Aviation if he is aware that the recent inclusive tour arrangements by British European Airways have the effect of making it cheaper for British residents to visit the Continent than for continentals to visit Great Britain; and if, in the interests of British tourism, he will try to secure some measure of reciprocity.

The Minister of Aviation (Mr. Roy Jenkins): I welcome the recent arrangements agreed by European airlines for cheaper inclusive tours on scheduled services which will extend the markets to a wider range of tourists. Because the traffic from this country is at present substantially larger than in the reverse direction, the airlines have so far found it possible to introduce the new arrangements only from this country. I hope, in the interests of increasing tourism to Britain, that they will soon find it commercially feasible to introduce reciprocal arrangements.

Mr. Shepherd: Is it not the case that, if drive, energy and some pressure were applied, the airlines would find such an arrangement commercially possible? This traffic was generated in Britain through the ingenuity largely of private fliers. Should not some pressure be exerted so that this country gets the benefit of trade from the Continent?

Mr. Jenkins: I hope that this will happen. The traffic flows very much outward rather than inward, but I hope that enterprise will be shown.

Air Routes (Costs per Mile)

Mr. Shepherd: asked the Minister of Aviation if he will state the average cost per mile of seats on British domestic air routes and European air routes.

Mr. Roy Jenkins: I assume the hon. Member is asking about the cost of travel to the passenger. Fares vary by route, by time of day and by season and an average fare can be misleading. However, in the financial year ended 31st March, 1964, British European Airway's average revenue per passenger mile was 5·3 pence per mile on domestic routes and 6·5 pence per mile on international routes.

Mr. Shepherd: Since a very heavy duty has to be paid upon spirit used for internal flights, which must add a very considerable cost to operations, how is it that there is much higher yield from domestic fares? Is it because of the restrictive arrangements of the I.A.T.A.?

Mr. Jenkins: I think that the hon. Gentleman is mistaken. There is not a much higher yield. The cost is higher on international routes although, in the case of the cost to the operator, the reverse is true.

Concord Aircraft

Mr. Peter Walker: asked the Minister of Aviation whether he will publish details of the representations he has received from the British aircraft industry on the subject of the Concord project.

Mr. Roy Jenkins: No, Sir.

Mr. Walker: Is the right hon. Gentleman aware that the White Paper on the Economic Situation, issued by the Secretary of State for Economic Affairs in


October and containing fierce reflections on the Concord project, together with the more recent announcement of certain American equipment being purchased for the project, have given the impression—wrongly, I hope—that the Government are not really keen on this project? Would not the publication of the reasons—or at least some of them—why they decided to go on with it give far greater confidence?

Mr. Jenkins: The hon. Gentleman is bringing in some very extraneous considerations. We are going ahead with the project and I hope and believe that it will be a success.

Mr, Peter Walker: asked the Minister of Aviaton whether he will publish details of the representations he has received from the French Government on the subject of the Concord project.

Mr. Roy Jenkins: No, Sir. The exchanges were confidential.

Mr. Walker: The right hon. Gentleman may think that some of the considerations are extraneous to this problem, but there is a feeling that the Government are half-hearted about the project. Would not the publication of the reasons why the right hon. Gentleman himself decided to go ahead with it benefit the future chances of Concord?

Mr. Jenkins: I have the impression that the hon. Member wishes to debate a decision that we made in January and not to ask for information about what took place.

Mr. Marten: asked the Minister of Aviation what is now the target date for the Concord being in airline service.

Mr. A. Royle: asked the Minister of Aviation what are the dates planned with the French Government for the first flight of the prototype and for the completion of the first production Concord; how many aircraft will be ordered by the British Overseas Airways Corporation; and what information he has as to when a firm order will be placed.

Mr. Roy Jenkins: The date of flight of the first prototype Concord aircraft is now foreseen as early 1968. We are discussing the development programme and time-scale thereafter with our French partners. Eight aircraft have

been reserved for British Overseas Airways Corporation but it is too early for firm orders to be placed.

Mr. Marten: Could the Minister answer the Question, which I think asked when he estimates the Concord will be in airline service? That is the question which I want answered. Secondly, can he say whether everything is being prepared to swing straight into production on this as soon as possible? Thirdly, is the electronics equipment being developed so that it will meet the time when production should begin?

Mr. Jenkins: As I indicated in my Answer, we are discussing with the French the date when it will come into airline service. What we are anxious to do—and I am sure that we carry the hon. Member and the House with us in this—is to get the market. Therefore, an important factor is how close America is behind us. But compatibly with getting the market we do not want to get into a position in which we act without due consideration. But, as I said on 20th January, we are determined not to spend the money and lose the market.

Mr. David Price: Would the Minister confirm or deny the date quoted fairly widely in recent weeks in the aviation Press that we would he in production of the Concord in 1972?

Mr. Speaker: Order. The Minister cannot be asked to confirm things in the Press unless he is responsible for them. Perhaps the hon. Gentleman can ask whether it is a fact, or something of the kind.

Mr. Price: Is it a fact and also would the Minister confirm that in order to be in production in 1972 the first metal for production has to be cut in 1968?

Mr. Jenkins: We are anxious to be in production at a time which will give us a substantial lead over any American SST. I prefer not to go beyond that at the moment, because this is a matter which we are discussing with our French partners.

Mr. Scott-Hopkins: By how many months or years has the mess and muddle which the right hon. Gentleman and the Government made put back the programme?

Mr. Jenkins: I can tell the hon. Gentleman precisely. We have not put it back at all. The programme went ahead during the period of review, and it made remarkably good technical progress during these months.

Mr. Rankin: Can my right hon. Friend say whether there is any prospect of an American competitor to the Concord?

Mr. Jenkins: I am sure my hon. Friend will appreciate that if I cannot answer for the British Press, I cannot answer for the American Government either, but I think that they are in the process of making a decision which may well be announced within the next month.

Belfast Freighter Aircraft

Mr. McMaster: asked the Minister of Aviation if he will place a contract with Short Brothers and Harland for a development study of a jet version of the Belfast freighter aircraft.

Mr. Stratton Mills: asked the Minister of Aviation if he will place a contract with Short Brothers and Harland for a development study of a jet version of the Belfast freighter aircraft to fulfil a dual strategic and tactical rôle.

Mr. Pounder: asked the Minister of Aviation if he will initiate a development study, to he conducted by Short Brothers and Harland, into a jet version of the Belfast air freighter.

The Parliamentary Secretary to the Ministry of Aviation (Mr. John Stonehouse): At present, there is no requirement for an aircraft of this kind. In these circumstances we would not be justified in placing a development study contract with the company.

Mr. McMaster: Is the hon. Gentleman satisfied that 10 strategic Belfasts are sufficient to meet the strategic transporting needs, particularly in view of developments in the Far East and our commitments there? Is he aware of the long time taken to plan and develop a new aircraft? Will he, therefore, think again about this project and couple the large configuration of the Belfast and its advantages with a British engine rather than order an American aircraft?

Mr. Stonehouse: I am very well aware of the long time required to develop a

new aircraft, but the question of military needs is for the chiefs of staff of the Royal Air Force.

Mr. Pounder: Am I to assume from the hon. Gentleman's Answer that the current aviation policy to buy American is long-term rather than short-term? Otherwise, why does he refuse to consider further a worth-while project such as a jet version of the Belfast?

Mr. Stonehouse: If a requirement of the type referred to is discovered, the Belfast will be considered.

V.T.O.L. Aircraft

Mr. McMaster: asked the Minister of Aviation whether he will place a further research contract with Short Brothers and Harland for the development of a new multi-jet vertical take-off and landing aircraft as a successor to the SC1.

Mr. Roy Jenkins: No, Sir. We have no requirement which could justify placing such a contract at present.

Mr. McMaster: Is the right hon. Gentleman aware of the advantages of a multi-jet vertical take-off aircraft, particularly in view of the development in the new Rolls-Royce jet lift engines which have a power-weight ratio of about 25 to 1? Would it not be better if such an aircraft could be developed in this country rather than by Dornier in Germany along with American participation?

Mr. Jenkins: I am studying this matter. We are most anxious to help Short Bros. and Harland. I know how pertinacious the hon. Gentleman is in putting forward that concern's claims. I will watch this matter. But I cannot, and should not, place contracts for things for which there is no requirement in view.

South Africa (Bloodhound Missiles)

Mr. Wall: asked the Minister of Aviation what inquiries have been made by the Government of South Africa regarding the purchase of Bloodhound missiles.

Mr. Roy Jenkins: It is not the practice to disclose details of such enquiries.

Mr. Wall: Is it not a fact that a letter of intent to order the Bloodhound was sent and a deposit paid? Is it not equally the fact that this is a wholly defensive


weapon? Was it not the Government who caused the cancellation of this £20 million order through their rather strange political ideas about South Africa?

Mr. Jenkins: No contract was placed Our "strange political ideas", as explained by the Prime Minister, were the result of a desire to come into line with a United Nations resolution which made it essential for us to take the action that we did.

Mr. Wall: Will the right hon. Gentleman explain to the people involved that this has cost them £150 million worth of orders?

Mr. Jenkins: I would prefer that the hon. Gentleman gave his own explanations.

Airports (Departure Charge)

Mr. Wall: asked the Minister of Aviation why, subsequent to the ending of the 7s. 6d. airport service charge, a 7s. 6d. United Kingdom departure charge is now levied; by what authority this charge is made; and whether he will make a statement.

Mr. Stonehouse: The departure charge was introduced by the international airlines to meet the costs of the Government's navigation service charge which came into force on 1st November. The departure charge was agreed in the International Air Transport Association as a temporary measure and was approved by all authorities concerned, except the United States of America. It will be withdrawn on 1st April when higher fares will be introduced on certain routes.

Aircraft Industry

Sir C. Osborne: asked the Minister of Aviation, in view of the fact that aircraft engine exports dropped from £62,706,680 in 1963 to £44,096,123 in 1964, what estimate he has made of the effect on exports of his policy with regard to the Concord and TSR projects; how many workers he expects to be made redundant; what are his plans to meet this problem; and if he will make a statement.

Mr. Roy Jenkins: As I said in my statement of 20th January, the Concord goes ahead. All being well, this project

may do a substantial amount of export business. As regards the TSR2, my right hon. Friend the Prime Minister told the House on 2nd February, no decision will be taken until a new more detailed assessment has been completed. The effect on the aircraft industry, including its exports, forms part of this assessment.

Sir C. Osborne: If we hesitate or refuse to buy our own products, is it not unreasonable to expect foreigners to buy them? If we prefer foreign manufactures to our own, how can we expect foreigners to choose British? Is not this doing us a lot of harm? Does the right hon. Gentleman see any hope in future of these exports improving?

Mr. Jenkins: These are general considerations. As I say, the Concord goes ahead, and we are studying the position about the TSR2.

Sir C. Osborne: Cannot the Minister give any hope to the workers in the industry—this is not a party matter; it is a very serious matter for the men whose jobs are at stake—that the future holds better prospects for them?

Mr. Jenkins: I hope that the future holds very good prospects for the industry. As I have indicated when I could answer at greater length, I am not prepared to spend public money without a good return.

Short Brothers and Harland, Belfast (Employment)

Mr. Pounder: asked the Minister of Aviation what proposals he has for maintaining employment at the present level in the Belfast aircraft factory after 1970.

Captain Orr: asked the Minister of Aviation whether he will make a further statement about the employment position at Short Brothers and Harland, Belfast, in view of recent Government decisions about procurement of aircraft.

Mr. Chichester-Clark: asked the Minister of Aviation how many are now employed at Short Brothers and Harland, Belfast; and what he estimates will be the position in 1970 following recent decisions by Her Majesty's Government regarding Service aircraft requirements.

Mr. Kilfedder: asked the Minister of Aviation what estimate he has made of the level of employment at Short Brothers and Harland, Belfast, if no new orders are placed; and when he anticipates placing fresh orders with the company.

Mr. Stonehouse: The total number employed by Short Brothers and Harland, in Northern Ireland at the end of January, 1965, was 7,630. We are urgently considering whether any extra aircraft work can be fed into the company in the immediate future. I would prefer not to comment on the position in or beyond 1970 until the industrial consultants, to be appointed by the First Secretary of State, have reported on the use of Short's facilities in engineering fields.

Mr. Pounder: In view of the fact that employment in Short's after 1970 is likely to depend to a considerable extent on the consultants' report, can the hon. Gentleman tell us who the consultants will be, or, alternatively, have the invitations been sent out and, if not, why not?

Mr. Stonehouse: We cannot yet announce who the consultants will be, but we are certainly considering what can be done in the short term to keep this firm employed.

Captain Orr: Would the hon. Gentleman speed the appointment of the consultants and ask them to report as soon as possible, because until something is done about the long-term future the present anxiety about employment will remain?

Mr. Stonehouse: I am well aware of the anxiety about employment, and I tried to put some of those fears at rest when I was in Belfast three weeks ago.

Mr. Chichester-Clark: I realise that it will be some time before the consultants come up with anything new or decisive, but does the hon. Gentleman realise that the anxiety is to keep the present level of employment and that this can be done only by the provision of further aircraft work? Can the hon. Gentleman say anything about the prospects over the Phantom or how soon that might come along?

Mr. Stonehouse: I would rather not comment on a particular proposal, but I

can give the assurance that we are considering what aircraft work can be fed in in the short term.

Trident and HS125 Aircraft

Mr. Marten: asked the Minister of Aviation what estimate he has made of the effect the cancellation of the HS681 and P1154 will have on the future of the Trident and the HS125 due to increased overheads.

Mr. Roy Jenkins: I know of no intention on the part of Hawker Siddeley Aviation to adjust the overheads applicable to the Trident and HS125 following abandonment of the HS681 and P1154 projects.

Mr. Marten: If the overheads should rise on these two aircraft—the Trident and the HS125—will they be taken into account when assessing compensation?

Mr. Jenkins: Yes. It must be borne in mind that Hawker Siddeley is also to be given orders for the P1127 and the Comet marine reconnaissance aircraft. This, to a large extent, from the production point of view, constitutes a counterbalancing factor.

Aircraft Industry (Joint Projects)

Mr. Peel: asked the Minister of Aviation what stage has been reached in regard to the projects in the aircraft industry being jointly carried out with Continental partners.

Mr. Roy Jenkins: As there are a number of projects and countries involved, any informative Answer is necessarily lengthy. Therefore, with your permission, Mr. Speaker, I will circulate it in the OFFICIAL REPORT.

Mr. Peel: Will the right hon. Gentleman say whether the projects which are now under consideration are spread widely over the European countries as a whole, and not just confined to one or two countries? Secondly, is he satisfied that any projects which he now has under consideration will prevent a very considerable amount of unemployment which the cancellation of British aircraft has threatened?

Mr. Jenkins: There are 12 projects touching six European countries—France, Germany, the Netherlands, Norway, Denmark and Turkey. Should


these projects seem worth while, as many of them do, we will pursue them extremely vigorously. It is possible to exaggerate substantially the amount of unemployment likely to be caused by any cancellations that we have so far announced.

Mr. Maude: Can the right hon. Gentleman say when he expects to make a statement about an agreement on the jet strike trainer?

Mr. Jenkins: That is a matter for my right hon. Friend the Secretary of State for Defence.

Following is the information:
We are participating with France and Germany in the joint development of the RB162 lightweight jet lift engine, and with France in the development of a tactical air-to-ground missile. With Germany and the U.S.A. we are evaluating the P1127 aircraft and the operational and logistic problems associated with V/STOL. We are studying with Germany the problems of applying V/STOL to transport aircraft. We are also co-operating with the Netherlands in the development of a medium-range ship-to-air guided weapon, and with Norway and Denmark as well as Turkey in the production of the American Bullpup air-to-surface guided missiles. These projects are proceeding satisfactorily.
As recently announced, discussions are taking place with the French authorities to align national requirements for light strike/ trainer aircraft. The two countries are also studying new airborne early warning systems to a jointly agreed specification.
We are exploring with the French and German Governments, and with others of our European allies, the possibilities of collaboration on a number of other projects. including tactical air defence missiles and military helicopters.
In the civil field the U.K. is, of course, in full partnership with France on the Concord project. In our joint communique of 16th February M. Jacquet, the French Minister of Transport, and I noted the excellent technical progress being made and reaffirmed our intention of pressing on with the programme. We also recorded our exchange of views on the possibility of Anglo-French collaboration in the design and development of a subsonic passenger transport for shorter routes and our agreement to study the matter further.
Through European Launcher Development Organisation we are developing the first stage of the launcher; two successful firings of Blue Streak have already taken place in Australia and a third firing is due to take place shortly in Australia.

Aircraft Industry (Computing Capacity)

Mr. Ian Lloyd: asked the Minister of Aviation what information he has

on the relative size of the electronic computing capacity of the British and United States aircraft industries and on the lead in development time for aircraft which is now given by a lead in computing capacity in this field.

Mr. Stonehouse: Figures are not available, and I do not believe that a comparison of this kind, even if it could be made, would mean very much. The British aircraft industry is, however, fully aware of the importance and value of the use of computers and, with Government encouragement, is expanding its computing capacity.

Mr. Lloyd: In view of the importance of the relationship between computer capacity and lead time, does not the hon. Gentleman consider that we need more information of this kind?

Mr. Stonehouse: We will certainly consider that.

Sir C. Osborne: Are American computers regarded as cheaper or better than ours? On what grounds are we going to buy American?

Mr. Stonehouse: We are satisfied that many very good computers are being made here in the United Kingdom, and we will encourage the British aircraft industry to invest in these.

Ballistic Missiles (Production Contracts)

Mr. Burden: asked the Minister of Aviation what action he will take to ensure that in future there is no possibility of overcharging by firms contracting with his department for the supply or development of ballistic missiles.

Mr. Fisher: asked the Minister of Aviation what steps he proposes to take within his department to ensure that there can be no unreasonable profit in future in contracts for the supply of ballistic missiles.

Mr. William Hamilton: asked the Minister of Aviation if he will make a statement on the progress he has achieved in ensuring that unduly high profits are not made in future contracts for the development and supply of missiles.

Mr. Roy Jenkins: The only sure way of preventing the possibility of excessive


profits on production contracts would be to price them all on actual costs. This would reduce the incentive to efficient production and might well lead to an overall increase in the prices paid. I am sure that it is right to continue to seek fixed prices at an early stage, provided my Department has adequate costing information. The Government accept the recommendation in Sir John Lang's second Report that the Department should have equality of information with its contractors up to the time prices are fixed.
Sir John Lang's Report has made recommendations for improving organisation and procedure in order to ensure better assessment of prices. As I informed the House on 9th February, a number of these recommendations are in line with views already formed in my Department, and action on them is in hand. The others are being studied.
So far as development contracts are concerned, it is normally impracticable to price them other than on actual costs. There is accordingly little danger of overcharging.

Mr. Burden: Would not the right hon. Gentleman agree that Sir John Lang's Report and the statement that he has just made make nonsense of the criticisms which were levelled at my right hon. Friend the Member for Preston, North (Mr. J. Amery) when he was Minister of Aviation, regarding the unfortunate Ferranti affair—and we are all agreed about that—which arose largely because it is not possible to assess the cost of new projects in which there is no previous standard of costing, and which take in an entirely new range of scientific knowledge?

Mr. Jenkins: I should not like to say that any answer of mine could make nonsense of all the criticisms levelled at the right hon. Member for Preston, North (Mr. J. Amery), but I hope—though no one can feel certain in this respect—that we might avoid this unfortunate situation in the future.

Mr. Hamilton: Can my right hon. Friend spell out in some detail what improvements have been made in this field within his Department since the Ferranti affair? Can he spell out precisely what stage negotiations have reached

with Ferranti in connection with the immense profiteering in which the firm engaged?

Mr. Jenkins: On the first part of the question, we are endeavouring to strengthen the whole of the staff concerned with price fixing. A director of administration is being appointed, one of whose tasks will be to improve the administration of the contracts division as a whole, and in particular to ensure that there is the fullest collaboration between contracts, technical costing, and accountant staff.
On the second part of the question, I hope that it may be possible to bring this negotiation to a conclusion in the fairly near future. It is not an easy negotiation.

Mr. Fisher: Would not the right hon. Gentleman agree that as the Lang Committee has been quite unable to recommend any way of ensuring that in future profits are not excessive, this really exonerates both his Department and my right hon. Friend the Member for Preston, North (Mr. J. Amery) from any blame in the past, and makes a nonsense of all the Labour Party criticisms of the previous Administration at the time of the General Election?

Mr. Jenkins: I have already dealt with that question. The Lang Committee has not been able to guarantee a way in which excessive profits are not made, but I hope very much that under the new Administration we will have no repetition of the Ferranti position.

Sir A. V. Harvey: Where it is not possible to arrive at a fixed price in the contract in the early stages, will the right hon. Gentleman consider putting independent cost accountants acting on behalf of his Ministry into the firm?

Mr. Jenkins: Yes, Sir. I will consider that.

Mr. Emrys Hughes: Did my right hon. Friend read the article in The Times on Monday in which it was stated that one of these missiles used by the Navy costs as much as £8,250? This is the cost of three to four houses. Does not my right hon. Friend think that he can do something to reduce this cost?

Mr. Jenkins: I think that my hon. Friend will appreciate that that is a different and wider question.

Mr. Marten: In view of the point made by my hon. Friend the Member for Surbiton (Mr. Fisher), may I ask the right hon. Gentleman whether he will invite his right hon. Friend the Paymaster-General to read again his speeches during the debate on the Ferranti affair, and perhaps make some appropriate apology for some of the things that he said about my right hon. Friend?

Mr. Speaker: I do not understand this. It cannot be the Minister's responsibility to perform these antics.

Phantom and C130 Aircraft

Mr. Hastings: asked the Minister of Aviation what British radar and control systems are to be installed in the Phantom and C130 aircraft to be purchased from the United States of America.

Mr. Roy Jenkins: I cannot at present add to the Answer that I gave to the hon. Member for Cheltenham (Mr. Dodds-Parker) on 10th March in reply to a similar Question.

Mr. Hastings: Is it not a fact that firms such as Cossor and Marconi do not even know yet what components or systems to tender for? Has he had any encouragement whatever from the Americans in this regard, and, if so, can we be told exactly what was said? Lastly, will the right hon. Gentleman recognise that, unless orders are found, there is a real danger that the design teams in this vital industry will be dispersed in the same way as the design teams in the aircraft industry?

Mr. Jenkins: I do not accept that the hon. Gentleman seriously expects me to tell him what was said in the course of exchanges with the American Government on the matter, apart from the desirability of getting on with Questions, but I am very anxious, subject to price and delivery date, to see as much British electronic equipment as possible included in these aircraft.

Mr. Maude: Can the right hon. Gentleman say whether it is possible for British firms to hope for any of this business, or was there a package deal done to include all American electronic equipment, including flight simulators, when the original agreement was signed?

Mr. Jenkins: Certainly not. It was a question of cost and delivery dates. Firms may hope, and I hope that the way in which they are able to contract will turn their hopes into reality.

Mr. Snow: Is it not a fact that the previous Government seriously neglected the development of aircraft electronic equipment in this country, and is it not a fact that our exports of aircraft are prejudiced as a result of that sorry record?

Mr. Jenkins: Yes, Sir.

Mr. David Price: Will the right hon. Gentleman give the evidence for his confirmation of his hon. Friend's Question?

Mr. Jenkins: I have given a good deal of evidence on these matters, and I shall be happy to do it in subsequent debates which no doubt we shall have.

Mr. Hastings: How can the right hon. Gentleman accuse the industry of that when it has not had the chance to tender for equipment in these American aircraft?

Mr. Jenkins: The hon. Gentleman has misunderstood me. I was not accusing the industry, but agreeing with my hon. Friend the Member for Lichfield and Tamworth (Mr. Snow) in accusing the previous Government.

Phantom Aircraft (Engines)

Mr. Hastings: asked the Minister of Aviation how many Spey engines are to be ordered from Rolls Royce for the Phantom; and what modifications to the existing engine will be necessary.

Mr. Roy Jenkins: It is not the practice to disclose the size of military orders. The engine is being developed for supersonic operation and will also incorporate re-heat.

Mr. Hastings: Is it not a fact that there are major design problems with this engine? Can the Minister tell the House when this aircraft will come into squadron service, and can he deny that the decision to cancel the P1154 was taken before he had any clear idea at all when the Phantom would be ready?

Mr. Jenkins: I hope that there are no major design difficulties. I am surprised


that the hon. Member seems to be advocating that we should not include British equipment in these aircraft. That is not my view. The decision about the P1154 has nothing to do with the Question on the Order Paper.

Mr. Burden: Is the Minister sure that by switching the Spey engine to the Phantom there will not be any difficulty regarding the performance or safety of the aircraft? This often happens.

Mr. Jenkins: I do not think that this is so. I am extremely anxious—apparently more so than is the hon. Member—to see the British Spey engine incorporated in the Phantom aircraft.

Mr. Ridsdale: Can the Minister say when the Phantom aircraft will be available?

Mr. Jenkins: Not without notice. This Question relates purely to the number and modifications of the engine.

Flying Facilities, North Devon

Mr. Peter Mills: asked the Minister of Aviation what proposals he has to provide facilities for private and commercial aircraft to operate in North Devon.

Mr. Stonehouse: Provision of aerodromes to serve local needs is primarily a matter for local interests; the Ministry of Aviation will gladly advise on all technical aspects. Local authorities have already been encouraged to look into the possibility of providing small landing strips for private and business fliers and have been sent particulars of what such strips require.

Mr. Mills: Will the hon. Member bear in mind the real need for commercial aircraft facilities in North Devon—I do not think there are any at the moment—as this is a development area, with new factories springing up? Perhaps he will use his influence to encourage these facilities in North Devon.

Mr. Stonehouse: We will bear that point in mind. If the authorities concerned will send us their proposals we will give them all the help that we can.

Mr. Kenneth Lewis: Is the Minister aware that I regret that I was not here when my Question No. 9 was reached, because of a rather high-flying lunch?

Does he really think that it helps private flying to cut the tax concession which private flyers have—

Mr. Speaker: Order. This is an old, unpleasant device, which I hope will not be pursued by anybody.

Aircraft Exports

Sir A. V. Harvey: asked the Minister of Aviation what assistance has been given by his Department to the British Aircraft Corporation in its negotiations with Middle East Airlines for the supply of VC10 aircraft.

Mr. Raphael Tuck: asked the Minister of Aviation what steps he is taking to assist the export sales of civil aircraft.

Mr. Stonehouse: I have recently discussed export promotion with the Export Council of the Society of British Aerospace Companies and, I am glad to say, our proposals for assisting exports were generally welcomed. Financial assistance is being given to projects which have a promising export potential. We are particularly in close touch with companies about export prospects including the VC10 for the Middle East Airlines. In this connection we have agreed to consider proposals the British Aircraft Corporation may care to submit for our assistance in disposing of aircraft which M.E.A. may have surplus if they purchase the VC10.

Sir A. V. Harvey: Is the hon. Gentleman aware that his Answer is good only as far as it goes? Is he further aware that a Middle East Airlines representative in London last month stated that the contract was in grave doubt because of the controversy over British military types and the possibility of not getting spares for this aircraft in years to come? Will he do what he can to remedy the situation and to assure these airlines that British spares will be available and that the Government intend to maintain the British aircraft industry?

Mr. Stonehouse: I am not only prepared to give that assurance here; I gave it directly to Sheikh Najeeb when I saw him here a few weeks ago. We are satisfied that the British aircraft industry will be in a position to provide these spares in years to come.

Mr. Tuck: Do the Government propose to give continuing support?

Mr. Stonehouse: Yes. We are satisfied that there is a great future for the export of civil aircraft from the United Kingdom, and we want to give this industry full support in its export drive.

Mr. Onslow: Does not the hon. Gentleman agree that one of the most encouraging steps that could be taken would be for B.O.A.C. to take up some of the suspended VC10 orders, thus showing what a splendid aircraft it is proving to be?

Mr. Stonehouse: As the House should know, B.O.A.C. is delighted by the VC10's performance. I hope that this will be an example to all airlines which are now considering buying the VC10.

Mr. Rankin: Although we are anxious to help these airlines and to supply them with aircraft, is my hon. Friend satisfied that Middle East Airlines are in a financial state which enables them to meet the payments, which formerly they could not?

Mr. Stonehouse: I do not believe that there is any financial or technical obstacle to the supply of VC10's to this airline.

Mr. Marten: Would it not help the prospects of exporting British aircraft if the Government said firmly that they would go ahead with the TSR2?

Mr. Stonehouse: That is a consideration that will be borne in mind when the decision has to be made.

P1154 and HS681 Aircraft

Sir A. V. Harvey: asked the Minister of Aviation how much has been expended on research and development in respect of the 1154 and 681 types of aircraft.

Mr. Roy Jenkins: The best estimates that can be made at present are that total expenditures on the P1154 and HS681 are likely to be of the order of £25 million and £4 million, respectively. Development contracts for both aircraft are now in process of running down.

Sir A. V. Harvey: In view of that very unsatisfactory Answer, will the right hon. Gentleman consider, even at this late

stage—and in view of the lead that the P1154 type of aircraft has in the world —keeping the nucleus of the design team on this project so that if our economy improves we can go ahead and catch up again, or even maintain the lead which we have today?

Mr. Jenkins: I explained in the debate we had a few weeks ago why we do not think it right to go ahead on this project. The fact that limited sums have been spent is no reason for spending additional sums on something which we do not think is well founded.

Mr. A. Royle: Can the Minister tell the House the exact cost of the 100 Kestrels with which it is intended to replace the P1154, and whether a firm order has now been placed for the Kestrels with the Hawker Siddeley group?

Mr. Jenkins: No, Sir. It is not the practice to disclose exact costs. We believe that it will be a very worth-while purchase, and we are proceeding to a position in which the firm can go ahead. The firm is in no way held up by lack of a firm order.

Mr. Maxwell: Does my right hon. Friend agree that if the former Administration had not dithered about the P1154 at the time, but had suported it with sufficient funds, there would be no question of needing to cancel it today?

TSR2 Aircraft

Mr. William Hamilton: asked the Minister of Aviation if he will now make a statement on the future of the TSR2 project.

Mr. Wingfield Digby: asked the Minister of Aviation if he will now make a further statement on the TSR2.

Mr. Roy Jenkins: The further review announced by the Prime Minister on 2nd February is not yet complete. Until it is, I cannot make a statement.

Mr. Hamilton: Can my right hon. Friend give any indication when this final announcement will be made? Can he give an assurance to those hon. Members on this side of the House who would like to see the project abandoned that the scientific personnel employed on the project could easily be absorbed in much more worth-while projects?

Mr. Jenkins: I cannot give an exact date when an announcement will be made, but a decision will be taken as soon as we have assembled all the relevant facts. We are anxious not to take a decision before we have these facts, and are anxious not to postpone the decision the moment after we have them.

Mr. Digby: Can the Minister confirm that the trials are going extremely well, and far exceed expectations? Will he also comment on the fact that there is a drift of skilled people from the project, and will he make up his mind quickly?

Mr. Jenkins: As is inevitable at this stage, there are some difficulties with the aircraft, but the trials, on the whole, are going well. The Government will make up their mind as soon as they can, but they will have to decide between the advice of the right hon. Member for Monmouth (Mr. Thorneycroft), who urged us to be slow in making up our mind on this issue, and that of the hon. Member for Dorset, West (Mr. Wingfield Digby).

Mr. Maude: Will the right hon. Gentleman give the House an assurance that he will be motivated in making his decision solely by the aeronautical and military considerations and not by the political pressure of his hon. Friends?

Mr. Jenkins: The Government—this is certainly a matter for the Government as a whole—in their decision will be actuated by a wide range of considerations. Certainly aeronautical, military and economic considerations as a whole and also certainly social and employment considerations.

Mr. Ioan L. Evans: Will my right hon. Friend assure the House that he will closely examine the defence white elephants built by the last Government and particularly those defence white elephants which they were trying to fly?

Mr. J. Amery: Is the Minister aware that grave anxiety has been caused in the industry by the suggestion of his right hon. Friend the Minister of Defence that there would be no need for a Canberra replacement in Europe and that, whatever decision the Government are likely to take on this question, this could mean a great contraction in orders for the TSR2? Can the Government clarify their position on this matter?

Mr. Jenkins: Clearly the need for a Canberra replacement in Europe is a matter for my right hon. Friend the Secretary of State for Defence and not for me.

B.E.A. Routes (Priorities)

Captain Orr: asked the Minister of Aviation whether, in view of the fact that internal routes have greater flight frequencies than overseas routes, he will give a general direction, in the public interest, to British European Airways that when a number of flights have to be can-celled or amalgamated due to insufficient de-icing facilities or other reasons, overseas routes shall have an absolute priority of service over other internal services.

Mr. Stonehouse: No, Sir. This is a matter for the airline concerned, but I understand that, if there is a choice, British European Airway's practice is to cancel the service that will cause least inconvenience and that they have the availability of alternative transport in mind.

Captain Orr: Is not the hon. Gentleman aware that in fact de-icing facilities at London Airport are now so inadequate that frequently early morning planes to Belfast during the winter have to be cancelled and that the position becomes more irritating in view of the fact that planes take off from Glasgow and other obscure places on the mainland?

Mr. Stonehouse: I will see that these observations are conveyed to B.E.A., but I understand from B.E.A. that very high priority is given to the Belfast planes.

Renfrew Airport (Fog Conditions)

Mr. Brewis: asked the Minister of Aviation whether Prestwick Airport is available as an alternative landing ground for British European Airways when Renfrew is fog-bound.

Mr. Stonehouse: Yes, Sir.

Mr. Brewis: As only passengers who wish to go to the west coast of Scotland, which includes Kilmarnock and Ayr, fly to Glasgow, is not it absurd that they should be diverted to Turnhouse on the east side and not to Prestwick which is nearer to their destination?

Mr. Stonehouse: Yes, Turnhouse could be used as a diversionary airport.

Mr. Manuel: Is my hon. Friend aware that people who are very sympathetic to airlines are concerned at what appears to be a lack of co-operation between B.E.A. and B.O.A.C. during fog conditions at Renfrew? Will he take some interest to see that there is the utmost co-operation by both airlines to fit together for the convenience of passengers?

Mr. Stonehouse: We are concerned that there should be the utmost co-operation between B.E.A. and B.O.A.C. I will see that these observations are drawn to the attention of the Corporations.

Mr. Rankin: Will that co-operation still exist when there are fog conditions at Prestwick?

Mr. Brewis: In view of the unsatisfactory nature of the reply, I wish to give notice that I shall endeavour to raise the matter on the Adjournment at the earliest opportunity.

Private Flying Clubs

Mr. Ian Gilmour: asked the Minister of Aviation what support, other than subsidy, Her Majesty's Government will give to private flying clubs.

Mr. Derek Page: asked the Minister of Aviation what support he will provide for flying clubs other than by subsidy.

Mr. Stonehouse: We give significant support to flying clubs, principally by placing with them substantial contracts for the flying training of cadets and technical personnel, by providing free landing facilities at State-owned aerodromes, and now by helping to finance the development of new British light aircraft.

Mr. Gilmour: Is the Minister aware that the Government give very much less support to flying clubs than practically every other country? Does not he realise that a lot of flying clubs had financial trouble even before the withdrawal of the fuel rebate? Should not his right hon. Friend be encouraging flying clubs and young air-minded people instead of making their activities extremely difficult?

Mr. Stonehouse: We want to encourage these flying clubs. I am not at all sure that the withdrawal of the rebate which

has been referred to was an undue hardship on the clubs.

Mr. Page: Would my hon. Friend bear in mind that the French Government backs its private flying clubs to the extent of £700,000 a year; that the Italian Government provides duty-free fuel; that the Canadian Government supports its clubs and that the support for our clubs is very poor in comparison?

Mr. Stonehouse: I do not wish to be drawn into these comparisons—[HON. MEMBERS: "Why not?"]—because I am satisfied, having gone into the facts, that we give very important assistance to these clubs. If there are any further suggestions which the clubs wish to make to me they can do so through a Committee which will meet in a few weeks' time.

Commander Courtney: Is the Minister aware that it is no earthly use for the Government to give £600,000 to the only British light aircraft manufacturer and at the same time abolish the Junior Wing Scheme, take off the petrol rebate and, generally speaking, put flying clubs out of business?

Mr. Stonehouse: As the hon. and gallant Member, who is very well experienced in these matters, knows, there are many other ways in which we can assist these clubs and we are doing that. We want to continue with constructive assistance.

Mr. Fell: Could not the Minister have a word with the Chancellor of the Exchequer and the First Secretary about the rebate before the Budget?

Mr. Stonehouse: The rebate question cannot be re-examined at this stage. We are prepared to look at any further constructive suggestions for assistance to these clubs. In fact, we provide free facilities for them at State-owned aerodromes, and I am proposing to ask the British Airports Authority, when it is set up, to continue the facilities for these clubs.

Mr. Maude: Is the hon. Gentleman really saying that if evidence is produced to show that the withdrawal of the fuel rebate is causing grave hardship, it cannot conceivably be re-examined? Is that what he really meant to say?

Mr. Stonehouse: What I said was that it cannot be re-examined for this year. If


in future years it is shown beyond doubt that any undue hardship is being caused, we will re-examine it. That is not the position at this stage.

Dr. Bennett: Does the hon. Gentleman realise that the steps he is taking to encourage flying clubs are insignificant compared with the blow struck by the abolition of the rebate?

Mr. Stonehouse: I am not satisfied that the withdrawal of this comparatively small rebate will have the effect suggested.

Mr. Snow: Is my hon. Friend aware that, while we must bear in mind the defence aspects of training pilots, there are also the interests of the economy to bear in mind and that we should not necessarily subsidise people who regard this just as a weekend sport?

Mr. Stonehouse: We are aware of those considerations. I ask the House to bear in mind that we are spending over £120,000 in financial assistance to clubs which undertake training schemes on our behalf.

Mr. Gilmour: In view of the unsatisfactory nature of the reply, I beg to give notice that I shall endeavour to raise the matter on the Adjournment.

London-Aberdeen Service

Lady Tweedsmuir: asked the Minister of Aviation whether he will instruct the member whom he will appoint to British European Airways' board, charged with paying special attention to the interests of the domestic passenger, to ensure that there will be two daily direct air services between London and Aberdeen, which now enjoys only one direct service daily.

Mr. Roy Jenkins: The scale of services operated by British European Airways must remain a matter of its own responsibility.

Lady Tweedsmuir: Is the Minister aware that, owing to his expressed confidence that the appointment of this one extra member was going to bring speedy and acceptable results for the domestic passenger, there will be great disappointment if he cannot give instructions in the sense of the Question, particularly as the tourist season is coming on? No doubt he will be aware that

owing to the cancellation of independent services to Glasgow and Edinburgh it is all the more necessary in the tourist season to have a direct service to Aberdeen and the North?

Mr. Jenkins: I have great confidence in the contribution which the consumer member on the Board will be able to make to the general pool of wisdom in B.E.A., but I am not going to start him off by giving a specific instruction about one service.

Mr. Marten: Can the right hon. Gentleman give any instructions?

Mr. Jenkins: The hon. Gentleman, who has had responsibility in these matters, is surely aware that I can give general instructions but not specific instructions.

Aircraft Accidents (Inquiries)

Dr. Bennett: asked the Minister of Aviation what steps he is taking at the International Civil Aviation Organisation and otherwise to ensure that in inquiries into aircraft accidents full investigation is made into the causes of death, injury or survival of individual victims, and that this information is published in the reports of such inquiries as being of equal importance to the aeronautical findings.

Mr. Stonehouse: The recent meeting of the Accident Investigating Division of the International Civil Aviation Organisation in Montreal at which the United Kingdom representative took a leading part, made recommendations which we support and which included proposals for investigating and reporting on survival and aero-medical aspects of aircraft accidents. These recommendations will be considered later this year by the Air Navigation Commission and afterwards by the Council of the International Civil Aviation Organisation.

Dr. Bennett: Such a report is certainly welcome, but does the hon. Gentleman know that an aeroplane will be just as dangerous to its passengers if it crashes into water a quarter of a mile offshore or if it goes over 400 miles before crashing? At present, the requirements for dinghies apply only to aircraft travelling at least 400 miles. Is this included in the material which is being considered now?

Mr. Stonehouse: This is being considered. We shall certainly bear that consideration in mind.

U.S. Airways (Impounded Aircraft)

Mr. A. Henderson: asked the Minister of Aviation whether he is aware that the flight of the Constellation belonging to the United States Airways engaged in transporting arms and ammunition and at present impounded in Malta originated in the United Kingdom; and what steps he is taking to prevent British airports being used in connection with illicit arms traffic.

Mr. Stonehouse: I would refer my right hon. Friend to the Answer given by my right hon. Friend the President of the Board of Trade to a similar Question on 25th February last; general questions about the transport of arms are a matter for my right hon. Friend the Foreign Secretary.

Mr. Henderson: In view of the fact that this gun-running operation is supposed to have originated from an airfield in this country, may I ask the Minister whether any undertaking has been received from United States Airways that no flights by its aircraft which are to be engaged in gun-running activities will originate from any airport in this country?

Mr. Stonehouse: I shall refer that point to the Foreign Secretary, but I am satisfied, as a result of the investigations which have been made, that the aircraft had no cargo taken aboard when it was at the airport in the United Kingdom.

Mr. Walden: Is my hon. Friend aware that the aircraft which was used for this purpose had already been engaged—as the company had been engaged—in a contract for a civilian flight, for which money had been collected which has not at the moment been returned?

Mr. Stonehouse: I am aware of that, but the Ministry did not allow the flight to take place because of the condition of the plane.

Airports, London and Renfrew (Lavatory Facilities)

Mr. Galbraith: asked the Minister of Aviation if he will improve lavatory facilities at London and Renfrew airports.

Mr. Stonehouse: Facilities at Heathrow for passengers using No. 2 Passenger Building (Britannic) were improved last December. New facilities for passengers arriving on domestic services will be available this summer.
While the facilities at Renfrew are in total sufficient, I agree that their distribution is not ideal. Renfrew Airport will however be closed in about a year, when the new Glasgow Airport at Abbotsinch is opened, and the provision of additional facilities at Renfrew would not in these circumstances be justified.

Mr. Galbraith: Is the Minister aware that, in spite of the improvements to the No. 2 Britannic section of London Airport, I know from personal experience, that there was a queue on Monday at no fewer than three lavatories? Is he aware that this gives a very bad impression to people arriving in this country? I include the international section too, because I have made a journey from there. It gives a very bad impression of the cleanliness in this country compared to that of other aerodromes, two of which—Brussels and Milan—I know well, and which are infinitely superior to anything in this country.

Mr. Stonehouse: The hon. Gentleman may like to read the Report of the Sanitary Ware Manufacturers two days ago, which gave special praise to the facilities provided at our airports. I freely admit, however, that when hundreds of people are arriving there in a particularly short period, the facilities can become congested.

Mr. Younger: Is the hon. Gentleman aware that the improvements going on to the domestic department at Heathrow seem to have taken an amazing length of time? Will he look into the possibility of improving and speeding up the work?

Mr. Stonehouse: We will look at that point, but we hope that these facilities will be completed by the summer, when the main rush is expected.

Sir A. V. Harvey: Will the Parliamentary Secretary agree to give the same urgency to this matter as the Government gave to the provision of bathrooms and private lavatories for Ministers?

Mr. Stonehouse: We will give it all possible consideration. In particular, we


want the facilities to be provided quickiy, because we are anxious that our airports should provide the best facilities.

Renfrew Airport (Taxi-Drivers)

Mr. Rankin: asked the Minister of Aviation why taxi-drivers are refused facilities for picking up passengers at Renfrew Airport.

Mr. Stonehouse: Taxi-drivers may pick up passengers when called from their rank which is about 100 yards from the terminal building. There is a clear line of sight between the two. Passengers usually have no problem in summoning taxis, but, in order to make it still easier, a call-button connected to an illuminated sign is being installed in the terminal building.

Mr. Rankin: While I thank my hon. Friend for that little concession, may I ask if he is aware that trouble still exists, and that it resides in the fact that, in 1953, the Tory Government granted Caledonian Cars a 12-year monopoly agreement at Renfrew Airport to provide services for air passengers at prices, unfortunately, which most of them could not pay? In view of the fact that that contract is now ripe for re-examination, will my hon. Friend look at it very carefully before he renews it?

Mr. Stonehouse: I should like to thank my hon. Friend for his initial observation. We shall certainly bear in mind what he has said. I am satisfied that there is room for a car-hire facility at this airport.

Sea Slug and Sea Dart

Mr. Sharples: asked the Minister of Aviation whether in view of the failure of the short-range Tartar and medium-range Terrier anti-aircraft weapons being developed for the United States Navy, he will approach the United States Government with a view to their purchase of similar British weapons which have been successfully developed, notably Sea Slug Mark 2 and Sea Dart, under the reciprocal arrangements which now exist.

Mr. Roy Jenkins: I am aware of un-official reports of difficulties over Tartar and Terrier. The United States authorities have been fully informed of the capa

bilities of Sea Slug and Sea Dart. It must be borne in mind, however, that missiles of this kind form part of an integrated ship system and cannot easily be substituted one for another.

Mr. Sharples: Is the right hon. Gentleman aware that the United States Government are said to be on the point of placing a development contract for the replacement of these two missiles, which have failed? Will he take a positive initiative to see that the American Government adopt British weapons which have been successfully developed—or is the trade to be entirely in one direction?

Mr. Jenkins: I am pursuing and will pursue, as vigorously as possible, efforts to make interdependence reciprocal.

Commander Courtney: Will the right hon. Gentleman bear in mind that Sea Dart in particular has a potential surface-to-surface capability, and, therefore, it will be of particular interest to the United States Navy?

Mr. Jenkins: I shall bring this to the attention of the United States authorities.

Mr. Maxwell: Would my right hon. Friend consider setting up a technical sales team at the Ministry of Aviation which would help plug the sales of British-made weapons to our Western allies, including the United States?

Mr. Jenkins: We are looking at this whole question of our export effort in aircraft and missiles and are acting as energetically as possible.

Mr. McMaster: Will the right hon. Gentleman also endeavour to sell the Short's Sea Cat—[HON. MEMBERS: "Hear, hear."]—to the United States Government as a small quid pro quo in return for the purchase of the C130 and the Phantom?

Mr. Jenkins: I shall bear in mind the hon. Member's point on this matter, as on all other aspects of Short Brothers' effort.

London Airport Departure Lounge (Stamps)

Mr. Berry: asked the Minister of Aviation why there are no facilities for buying stamps in the departure lounge of London Airport.

Mr. Stonehouse: I am glad to say that arrangements have now been made for postage stamps to be on sale from the 17th April next in the departure waiting rooms at Heathrow. We hope this facility will be of assistance.

Mr. Berry: Is the Parliamentary Secretary aware that this is the first Question which I have asked in the House, and will he ask his right hon. Friends always to give such satisfactory Answers in future?

Mr. Stonehouse: I can assure the hon. Member that we welcome such helpful Questions. We are certainly very anxious to improve and develop the facilities at Heathrow and at all the airports for which we are responsible.

Plowden Committee

Dr. Bennett: asked the Minister of Aviation whether the requirements of civil aviation are within the terms of reference of the Plowden Committee.

Mr. Roy Jenkins: The terms of reference of the Plowden Committee, which I announced to the House on 9th December, 1964, relate to the future of the aircraft manufacturing industry. The Committee is concerned with civil aviation to the extent that civil operators have requirements which could be met by the products of the industry.

Dr. Bennett: Is it not a fact that civil exports of the industry, for instance, cannot be considered without considering civil and military matters almost as a whole? Is this sufficiently covered by the terms of reference of the Committee?

Mr. Jenkins: Yes, Sir, I am sure it is.

Aircraft Projects (Commonwealth Co-operation)

Mr. Bryant Godman Irvine: asked the Minister of Aviation what discussions he has had with Commonwealth countries on the possibilities of Commonwealth cooperation in aircraft projects.

Mr. Roy Jenkins: Standing arrangements exist, and will be maintained, with Commonwealth countries for discussions in this field and in all fields of mutual interest.

Mr. Irvine: As there is an important aircraft industry in both Canada and Australia, is this not one of the first things

which the right hon. Gentleman should do to improve the facilities in this country?

Mr. Jenkins: Yes, Sir. We are anxious to collaborate in this field with our friends and allies, in Europe, across the Atlantic and in the Commonwealth, and we do not regard collaborative enterprise in one direction as exclusive in any sense.

Satellite Launchers and Sounding Rockets (Development)

Mr. David Price: asked the Minister of Aviation if he will make a statement upon Her Majesty's Government's programme for the further development of satellite launchers and sounding rockets.

Mr. Roy Jenkins: Pending a review of United Kingdom interests in space, including the defence interests to which my hon. Friend the Prime Minister referred in his reply to the hon. Member for Hendon, North (Sir Ian Orr-Ewing) on 24th February, I am not prepared to make a statement.

Mr. Price: Will the right hon. Gentleman make it clear today whether this means that the Black Arrow project, as successor to Black Knight, has either been put back or been abandoned?

Mr. Jenkins: No, Sir. I do not want to go beyond what I said on this matter today, but the hon. Member would not be right in making any pessimistic assumptions.

V.T.O.L. Aircraft (Joint Programme)

Mr. David Price: asked the Minister of Aviation if he will give details of the joint British-United States programme to develop vertical take-off and landing aircraft.

Mr. Roy Jenkins: The only joint V.T.O.L. aircraft programme we have at present is the P1127 Tripartite Evaluation Programme which we are undertaking with the United States and Federal German Governments. The evaluation phase of this programme is due to start next month at West Raynham.

Mr. Price: Will the right hon. Gentleman assure the House that we shall not give to the Americans information of a


field of aviation in which it is a common view that we are ahead of them, when in other fields the Americans expect us to buy from them and do not give any reciprocal orders in return? This subject has gone the whole way through Questions today. We are very worried about it.

Mr. Jenkins: We shall certainly not act in such a way as to give the Americans information which we do not regard it as in the interests of this country to give. But we have suffered very much, in my view, from the inability of the previous Government to make up their mind between the P1127 and the P1154.

Mr. A. Royle: As the Secretary of State for Defence announced to the House that his Administration intended to give a firm order for 100 P1127s to Hawker Siddeley, may I ask when this firm order will be placed, particularly as earlier this afternoon the right hon. Gentleman denied that they intended to do it?

Mr. Jenkins: Whatever else that has to do with, it has nothing to do with British-United States programmes.

Mr. Rankin: On a point of order. Is it in order for me to point out that Aviation has done 45 Questions? Should not that earn us another day in the week?

Mr. Speaker: I do not think it is in order, but let us share the good things of life.

Mr. A. Royle: On a point of order. In view of the unsatisfactory nature of the reply, I beg to give notice that I shall raise the matter on the Adjournment at the earliest possible moment.

QUESTIONS TO MINISTERS

3.31p.m.

Mr. Speaker: I have a statement to make to the House about one aspect of Questions, and I apologise in advance for the length of it.
Supplementary questions are not a matter of right. They are solely within the discretion of the Chair, but by the practice of my predecessors and myself Members have been led to hope that they may be called to ask a supplementary ques-

tion if they have a Question on the Order Paper which is answered together with another Question.
It may not have escaped the notice of the House that lately Members on both sides of the House appear to have been studying the Order Book and putting down Questions somewhat similar to Questions already on the Paper. I can only assume that they hope that their Questions, although too low down in the list to receive an oral Answer if called separately, will, in fact, be answered with the early Question and that they will by these means gain a chance of being called to ask a supplementary question. If they are, the result is to deprive other Members of their right to get an oral Answer to their Questions which were on the Paper—a right which it is my duty to try to protect.
I will point out that there is nothing in itself wrong in similar Questions appearing on the Order Paper for the same day if the same point occurs separately to individual Members. The element of disorder arises only if it appears that Questions are being duplicated as a result of a deliberately organised campaign, and then only after a considerable number of similar Questions have established the campaign beyond doubt.
On the last occasion that the Chair intervened publicly, my predecessor held his hand until 25 Questions had appeared on the Paper. It would be difficult to apply the rule applied by my predecessor to the present problem, since the numbers of these late Questions are much smaller. It is often a matter of two or three late Questions tacked on, if I may use that expression, to an earlier one, and in many cases it is not possible to establish that this is done on purpose.
The matter will no doubt be considered by the Committee on Procedure, and I shall welcome their guidance in the matter and that of the House when the Committee reports. I have, nevertheless, been disturbed about the extent to which this practice has been growing and apprehensive lest it should reach unmanageable proportions before the Select Committee on Procedure is able to make its report. I am sure that the House will appreciate that if seven Questions were tacked on to each of the first 10 Questions to the Minister who was at the top of the list, we should never


get beyond Question No. 10 if supplementary questions were allowed for each one of them.
The matter was brought to a head yesterday afternoon when I was shown 25 Questions which had been brought in that morning by one Member at the last possible time for giving notice, addressed to the Secretary of State for Education and Science, who already had some 60 Questions addressed to him on the Paper for Thursday. I examined the Questions and noted that, although they were in the names of different Members, 18 of them appeared to be in the same handwriting. I then observed that they could be divided into seven groups, each of which was similar to a Question which appeared in the first 15 Questions addressed to the Secretary of State for Education and Science for Thursday. The largest group was one of nine Questions, all practically identical.
I hope that the House will agree with me that in these circumstances, which may be repeated, the Chair must take action without waiting for the report of the Committee on Procedure. This is what I propose to do. I am, however, anxious to take that course which is least likely to prejudice the issue to be determined by the Committee or to make it more difficult to adopt whatever solution the House may eventually think best.
The best course, in the circumstances, appears to me to allow these tacked-on Questions to go down upon the Order Paper, but to exercise a discretion in the calling of supplementary questions. I therefore propose in future, while doing my best to preserve a fair balance, to regard Members whose Questions have late numbers, when Questions are answered together, as having no more reason to catch my eye for a supplementary question than Members who have no Questions on the Paper. For the purpose of deciding what is a late number I shall draw the line somewhere about No. 50, or No. 10 in the case of a Question addressed to the Prime Minister
There may be many alternative answers to this problem and many things which could be said for or against each of them. I do not, however, see how I can avoid making a choice here

and now, and I hope that it will commend itself to the House until such time as the Committee has reported.

Mr. Shinwell: You will recall, Mr. Speaker, that the other day my right hon. and learned Friend the Member for Rowley Regis and Tipton (Mr. A. Henderson) made a submission to you on this question because the procedure which had been adopted in the House was preventing hon. Members from having their normal Questions answered by members of the Government. [HON. MEMBERS: "Speech."] I hope that the House will be satisfied that the matter should be left in your discretion. [HON. MEMBERS: "Speech."] The House will be gratified that you have—

Mr. Speaker: Order. I was assuming that the right hon. Gentleman had risen on a point of order. I do not think that we can have a general discussion of this subject now. I appreciate his kindness in expressing gratitude for the proposed state of affairs.

Mr. Shinwell: What I am proposing to do, Mr. Speaker, with your consent, and irrespective of the rude noises from the other side of the House, is to thank you for your submission to the House pending—this is perhaps a point of order—submission to the Committee on Procedure; and in the meantime to accept your discretion on matters of this sort. Can it be clearly understood that, subject to your discretion, there is no intention of abandoning normal supplementary questions? The House is dull enough as it is.

Mr. Speaker: I did not say anything about that. The circumstances which I described were, in my view, slightly abnormal.

Mr. William Hamilton: I thank you for the letter which you sent me this morning, Mr. Speaker, and I fully accept the inference of guilt which it carried. It was my handwriting which was on the Questions put in yesterday. I hope that you will be aware that the exercise was done with intent. [HON. MEMBERS: "Oh."] I ask you to bear in mind that the abuse of Question Hour started not on this side—

Hon. Members: Oh.

Mr. Speaker: Order. As I pointed out, whoever started it, both sides have been doing it. I propose to put a stop to it. I do not think that it will assist the matter to bandy accusations now.

Mr. Hamilton: You have made a Ruling, Mr. Speaker, as I understand it, on what you propose to do with regard to supplementary questions to Questions which appear after No. 50. It would be as well if you bore in mind, when deciding that, that the reason why Questions are put down after No. 50 is because the Notice Paper has been monopolised for months in advance by hon. Gentlemen opposite.

Mr. Speaker: I do not want any advice from the hon. Gentleman. I seek to discharge my duties as fairly as I possibly can. I shall not be able to work this without an occasional injustice, but it will be unintentional.

Mr. Snow: On a point of order. The substance of your statement means, in effect, that the responsibility for sorting the present abuse of the Order Paper lies with a recommendation which may come before the House from the Select Committee on Procedure.
I put it to you, Mr. Speaker, as a point of order, in dealing with the House on these matters, does not a great share of the responsibility for the number of supplementary questions fall on the Chair? Although I place no particular importance on the figures I have produced, I have been looking back on the records and I find that since 1954—very approximately; I put it no higher than that—there are about 120 per cent. more supplementary questions per Question being allowed by the Chair.

Mr. Speaker: I am obliged to the hon. Gentleman. I have reason to think that he is himself a member of the Committee on Procedure. I have no doubt that in due course the Committee will be receiving statistics. I do not commit myself to saying that the conclusion to be derived from them is that derived by the hon. Gentleman at the moment. If I were given a chance I would hope to have an opportunity of perhaps discussing other matters, but I do not think that in this instance that can arise on what I have been saying.

Mr. Michael Foot: When you said to my hon. Friend the Member for Fife, West (Mr. William Hamilton) that you did not wish for advice from hon. Members on this matter, Mr. Speaker, is it not quite open to hon. Members to offer advice on these matters, particularly when my hon. Friend was stating, I thought perfectly clearly and perfectly courteously, that when he adopted the course which he took he was doing it only to deal with another abuse which. Mr. Speaker, has not been dealt with by your statement? I would, therefore, ask you whether you would accept the advice of my hon. Friend on this matter?

Mr. Speaker: Not on this matter. My statement does not give rise to anything, except what I said in it. It was made on a quite distinct point and all this is irregular. I like advice from hon. Members if made on the right occasion, but I must choose the occasions on which I can receive it.

NATIONAL BOARD FOR PRICES AND INCOMES (CHAIRMAN)

The First Secretary of State and Secretary of State for Economic Affairs (Mr. George Brown): I am authorised by the Prime Minister to inform the House that Her Majesty the Queen has been pleased to indicate her approval of the appointment of the right hon. Gentleman the Member for Birmingham, Hall Green (Mr. Aubrey Jones) as Chairman of the National Board for Prices and Incomes.
The names of the members of the Board will be announced in the near future.
The House will also be pleased to know that good progress is being made in the discussions with the other parties concerned about the considerations which should govern the behaviour of prices and incomes and by which the Board will be largely guided.
I hope to make an announcement about the outcome of these discussions soon.

Mr. Heath: Is the right hon. Gentleman aware that he is to be congratulated on having secured for this important appointment the services of one, perhaps the only one, who is acceptable to both sides of industry? Is he further aware that the whole House will agree with


him that it was right to look at the whole field to secure such a person and that my right hon. Friend, if it is still correct to use that designation of him as being a Member of the House, was right to respond to this approach in the way he has done in the national interest?
Could the right hon. Gentleman give us a dearer statement as to when he hopes to tell the House the remainder of the information mentioned in his statement? Does he, for example, expect to be able to tell us before the Budget?

Mr. Brown: I am obliged for what the right hon. Gentleman said about his right hon. Friend. It contrasts clearly with what was said about the appointment of a Labour man the other day to a different post.
As to the rest of the statement, I cannot at this moment, for reasons which the right hon. Gentleman will understand, go further than what I said in my original remarks. I will announce it, I hope, very soon; and by "very soon" I mean as soon as I possibly can.

Mr. Grimond: I, too, congratulate the First Secretary on having obtained the services of the right hon. Gentleman the Member for Birmingham, Hall Green (Mr. Aubrey Jones). I personally regret his departure from the House and feel that in many ways he might have done a greater service as a Member of Parliament, even as a member of the Conservative Party.
Would the First Secretary say with whom he is having the discussions to which he referred and, among the parties with whom he is discussing this, which specifically represent the consumers' interests?

Mr. Brown: The discussions are proceeding at the moment with the Trades Union Congress, the manufacturers, the employers and the various other bodies of which one broadly speaks as being on that side of industry. I think that, on the whole, the consumer is fairly well represented in me. [HON. MEMBERS: "Oh."]

Mr. Shinwell: Could my right hon. Friend say how far this process of the erosion of the Tory Front Bench is to continue? Is he aware that the prospect of thinning out the Tory Front Bench fills me with alarm and despondency?

Mr. Brown: My main aim, although it has nothing to do with the exercise here, would be to see the Tory Front Bench filled up and improved.

Mr. William Clark: Could the right hon. Gentleman say when he expects to be able to be a little more explicit about the terms of reference of the Board?

Brown: I said in my main remarks that as soon as we are through the consultations which are now taking place I will come to the House and announce the conclusions.

Maxwell: Could my right hon. Friend say what salary the Chairman of this Board will be paid and whether he will have independent staff resources to fulfil his very important duties in the national interest?

Mr. Brown: Yes. We will discuss the staff requirements with the Chairman of the Board. My intention is that he should have his own secretariat. How far it needs other staff than that which already exists, for example, within the N.E.D.C. office, or in my Department, we can discuss with him.
The Chairman's salary is £15,000 a year, which represents, I understand, a substantial financial sacrifice on his part.

Mr. Heath: Is the right hon. Gentleman aware that if he will appoint as chairmen of his regional councils gentlemen, and ladies, who are likewise acceptable to both sides, he will not find himself subject to the criticism that he has had so far?

Mr. Brown: The right hon. Gentleman must get it out of his head that only a Conservative is acceptable to both sides. Sometimes a Labour man is.

Several Hon. Members: rose—

Mr. Speaker: There are all the indications that we should now go on to farm prices. Mr. Peart.

AGRICULTURE (ANNUAL PRICE REVIEW)

The Minister of Agriculture, Fisheries and Food (Mr. Frederick Peart): With your permission, Mr. Speaker, and that of the House, I should like to make a statement on this year's Annual Agricultural Review, the details of which are


given in a White Paper available in the Vote Office.
One of the Government's aims in this Review has been to promote developments in agricultural policy which we believe must be made if the industry is to go on increasing productivity, and so improve its income while reducing its need for Exchequer support. One of agriculture's main problems is the wide differences between farms. There are many farm businesses which already provide a satisfactory full-time livelihood. But there are far too many others which, because they need better management or are too small in size, cannot do so at reasonable prices. Our objective is to create conditions in which such farmers can raise their standards.
In this Review, we are making a start on these longer-term developments by introducing a number of new production grants and revising some of the existing ones. We shall help the smaller farmer to improve his farm business by making better farm management the essential object and condition of a small farmer grant. At the same time, we shall extend the upper limits of the schemes so as to make them available to many more farmers, particularly the smaller dairy farmer and livestock rearer.
We are also introducing wider agricultural credit facilities, and providing grants for agricultural co-operative marketing. In addition, we are concentrating more help on the hill and upland areas. The hill-sheep subsidy will be made an annual grant on a flat rate; the hill-cow subsidy rate will be raised, and we are bringing in new winter-keep arrangements. There will also be an urgent review of the more fundamental long-term problems in the hill and upland areas.
These measures will give help to those in special need who are willing and able to help themselves. But many of the smaller farm businesses, if they are to succeed, must also obtain the advantages which come from larger-scale production or marketing. We are, therefore, planning measures to encourage an increase in the size of holdings on a voluntary basis, and to extend further help to agricultural co-operation over a wider field.
Turning, now, to the present position of agriculture generally, actual farm income for this year is expected to be £472 million—a record figure, and £63 million more than last year. Adjusted for normal weather conditions, the forecast for this year is £456½—about £30 million more than last year. Output is up substantially, and the growth in productivity has continued.
Coming to the commodities, let me deal, first, with milk. A number of producers are still giving up dairying, but the fall in the dairy herd now seems to have been checked, and production has risen slightly. Producers' prices have gone up appreciably. In view of the importance of the dairy herd, not only for milk but also for beef, the Government have decided to increase the guaranteed price by 1d. a gallon. This change, together with increased distributive costs, will require the retail price to be raised by ½d. per pint with effect from 1st August.
After a temporary decline, the beef herd is now recovering. But, in view of future world prospects, we are encouraging expansion of home production by an increase in the guaranteed price of 4s. per cwt. At the same time, we are widening the calf subsidy to bring in more calves and increasing the rate by 10s. We are also increasing the hill-cow subsidy by £1. The sheep breeding flock continues to grow, and no change will be made in the guaranteed price for fat sheep or for wool. The new flat rate subsidy for hill sheep will be 18s., compared with an average of 9s. 6d. over the last five years.
Pig numbers have considerably increased, and a further substantial rise is forecast. For much of the last year, however, the market for pigs has been reasonably strong and, in view of this, the Government have decided to raise the middle band—in effect, the standard quantity—by 900,000 pigs. We are also widening the middle band, and the steps on either side of it, so as to make changes in the guaranteed price less frequent. The decision, first announced two years ago, to abolish separate stabilising limits and to reduce the quality premiums will now be implemented.
The combined effect of all these steps would considerably increase profitability and so run the danger of encouraging


too high a level of pig production. As some offset, the basic guaranteed price will, therefore, be reduced by 1s. 7d. per score, but the immediate net effect will be that, on average, pig producers will be getting 11d. per score more than at present.
This year, egg production has outrun demand. Although there are signs that production next year may be somewhat less, technical efficiency is still increasing. To try to avoid a return to surplus, the guaranteed price for eggs will be reduced by 1d. per dozen.
Cereals production has risen to a very high level this year. In consequence, we are obliged, under the cereals agreements on minimum import prices made by the previous Conservative Administration, to take remedial action with the purpose of restoring a fair and reasonable balance between home-grown and imported cereals. The standard quantities for wheat and barley will be increased to take account of the growth in consumption, but the guaranteed prices will be cut by 1s. 1d. and 1s. 4d. per cwt. respectively. The guaranteed price of potatoes and sugar beet will be increased by 5s. and 2s. 6d. per ton respectively. The fertiliser subsidy will be reduced by £2 million, and the lime subsidy by £750,000.
The net effect of the Review decisions will increase the total value of the guarantees by over £10 million. This will mean that in the present circumstances of the national economy, the agricultural industry will, like others, be expected to absorb this year, through its increasing productivity, a large part of its increased costs of about £29 million. The present determinations will, however, give the industry the opportunity to improve its income, and a start has been made on policy developments of great importance to the industry in the longer term.

Sir M. Redmayne: Is the Minister aware that we shall study the detail of the preamble of his statement with some interest? But is he also aware that the body of his statement will be received with dismay, not only by farmers but by the millions of people throughout the United Kingdom who depend on a prosperous farming industry?
Does the right hon. Gentleman really maintatin that 1d. a gallon milk will stop

the drift from dairy farming? Will he not be said in this matter to be penny wise and pound foolish? Nothing is said of the standard quantities for milk. Are they increased? If so, what will be the product of that increase, and does it provide in any sensible way for the increased costs of the industry?
Where does the right hon. Gentleman stand on the brave statement he made at the last Dairy Show that there would be an assurance of stability? Is this an assurance of stability for the industry? Equally, of what worth are minor improvements for small farmers when so many small men depend on a reasonable price for milk to pay them a living? Is the Minister satisfied that 4s. per cwt. for beef will give the impetus that scarcity demands? What has happened to his own previous conviction, publicly stated, that there should be longer-term guarantees, as has been done before in similar conditions?
What are the increases in the standard quantities for wheat and barley? Is it not true to say that the cuts made are the maximum under the Acts? Is it necessary on this scale, or has there been, as we have good reason to suppose from previous things said on these occasions, some political prejudice against the big grower?
I will not weary the House with further questions. [HON. MEMBERS: "Hear, hear."] We shall undoubtedly want a debate on this Review. In view of its nature, I feel that that debate should be in Government time and should be soon.
Finally, I should like to ask the Minister where he himself now stands, in view of all the grave statements he has made during the last 18 months, of which I give one example,
Farmers have nothing to fear but much to gain from a Labour Government".
Where does his party stand in respect of its manifesto—
Farmers, too, will be given a new certainty."?
After this Review, the only certain thing in farming will be uncertainty as to the intentions of the Labour Government. I would ask the Minister what his own intention is and whether he intends to resign.

Hon. Members: Resign.

Mr. Peart: I hope that hon. Members opposite will listen to my reply to the right hon. Gentleman. We are giving an award which means for the milk producer a further increase of £11 million. Nine million pounds will come from the increase in the price per gallon and £2 million will come from the increase in the standard quantity. This is an award of £11 million more than they had last year. It is on top of last year's award. This really is generous. [HON. MEMBERS: "Oh."] Let me explain to hon. Members. They must listen to the facts. Apart from the last Price Review, which was in an election year, this is the most generous award for milk since the scheme was introduced in 1954–55.
I turn to the global award of £10 million. I would remind the House of the figures under the Conservative Administration: 1957, plus £14·27 million; 1958, minus £18·90 million; 1959, plus £3·04 million; 1960, minus £8·96 million; 1961, plus £14·16 million; 1962, minus £10·85 million; 1963, no change; last year, which was an election year, plus £31·22 million. This year, in the interests of the nation, it is plus £10·43 million.

Mr. Turton: Will the Minister say whether this is an agreed Review?

Mr. Peart: It is not agreed. Very few previous Price Reviews were agreed under a Conservative Administration.

Mr. John Hynd: Is my right hon. Friend aware that many hon. Members on this side of the House are not inspired to learn that another £11 million is to be poured down the drain for this industry, which is a free enterprise industry? Despite the howls of protestation from hon. Members opposite, they are only too anxious to milk the national cow. Why do we apply two distinctly different principles in the case of the agricultural industry and, for instance, the transport industry?

Mr. Peart: I believe that this award of plus £10 million is reasonable and right in the national circumstances. Added to that, the Review outlines a long-term policy for the industry to make it more efficient. We believe that this is the right approach.

Mr. Stodart: What are the different types of calves that the Minister proposes to bring into the subsidy? Is he aware that, although his award to the hill sheep industry is welcome, what he has said will do absolutely nothing for the keeper of low-ground sheep, who has been swinging over to grain, which is a more profitable undertaking? Does the Minister think it logical to cut the fertiliser subsidy at a time when his policy is directed at increasing beef, which requires more and better grass, which, in turn, requires the incentive of fertiliser?

Mr. Peart: As will be seen from the White Paper, new arrangements for calf subsidies will enable heifer calves, for example, now to qualify, and this will be a major step forward.
On the question of my approach to hill farms, I think that what I am proposing will be acceptable to the industry. We are increasing subsidy rates. I also emphasise, as I have stressed in my Statement and in the White Paper, that we are embarking upon a new Small Farmer Scheme which will help many sections of the industry. We think that this is right.
On the question of fertilisers, obviously we cannot go on continually seeing the fertiliser subsidy increase. We are making a small adjustment.

Sir G. de Freitas: My right hon. Friend referred to grants for co-operation. Is he aware that many of those engaged in agricultural co-operation would prefer long-term loans repayable at market rates to enable them to enter food processing, rather than grants of money under schemes which restrict the co-operative enterprise which is now in the land under the auspices of co-operative organisations?

Mr. Peart: I am anxious, as I have said, to have grants for aid under the Small Farmer Scheme, which is important. This will bring in approximately 40,000 more farmers. We are extending the principle of co-operation that is now enjoyed by the horticultural industry under the 1964 Act. I am extending this to agriculture generally. I am also having a special investigation of the whole future long-term approach in relation to credit and co-operation.

Mr. Grant-Ferris: Does the right hon. Gentleman realise that in my constituency of Nantwich, where there are probably more dairy farmers than in any other constituency, his statement will be regarded with the utmost gloom and despair? Does he further realise that the trend which started in the last Review, or going towards the 25 per cent. increase which farmers have claimed, has now been absolutely reversed? Does he not think that he will, in all probability, go down as the most hated Minister of Agriculture there has ever been?

Mr. Peart: If the hon. Gentleman uses such extravagant language as that, he must be responsible for it. I hope that I will go down as a reasonable Minister who has also to take the interests of the nation into consideration. After all, we are increasing the amount for the milk producer by £11 million. I also have a responsibility to the consumer.

Mr. Hayman: Will my right hon. Friend say what progress is being made in the talks about the egg guarantee system between producers and the Egg Marketing Board?

Mr. Peart: Those talks are still continuing with the Board and the producers. I am waiting for further discussions with them.

Mr. Kitson: Is the Minister aware that, although many of us on this side of the House recognise the interest he has in agriculture, we are absolutely shattered that he is incapable of carrying his Front Bench with him? The only reasonable thing he could do is to resign. Would he tell us what the cost to the consumer would be of ½d. per pint over 12 months?

Mr. Peart: This increase of £11 million is the most generous given to the industry, apart from in an election year. Specifically, it will mean ½d. a pint for four months; that is true. This will have to be borne by the consumer. One has to balance in the interests of the nation what is right, and I think that this is reasonable.

Lady Megan Lloyd George: Is the Minister aware that, with the exception of the pre-election Price Review, this is an infinitely more satisfactory Price

Review than any produced by the Administrations of hon. Members opposite. May I, therefore, congratulate the Minister on a sane, balanced and fair Review? May I also welcome the special assistance that has been given to small farmers and hill farmers? Would he tell the House something of the terms and the form of the agricultural credit which he proposes? Further, when does he hope to set up the meat and livestock commission, which is an immediate and urgent necessity for the future long-term planning and efficiency of the industry.

Mr. Peart: On the specific proposal for the marketing of meat, I believe that the introduction of orderly marketing is important and, therefore, we must act quickly. I have already sent out letters to the organisations in the meat industry who are affected, and to the producers, giving details of my proposals for a meat commission. I shall be discussing the matter with those interested parties I believe that this is urgent.
Again, on the question of the award, it will be seen from the figures that this is one of the most generous awards that we have had in the circumstances. There has been extravagant talk about 6d. on a gallon of milk. This would have meant an increase of £50 million to the producer, but we could not do this. I hope that hon. Members opposite will be reasonable.

Mr. Kimball: Is the right hon. Gentleman aware that this Review will lay firmly to rest once for all the ghost of the noble Lord, Lord Williams of Barnburgh, in the country areas, and that the Review will be greeted with sorrow as much as with anger throughout the countryside?

Mr. Peart: I cannot accept that. If the hon. Gentleman will carefully read the White Paper he will see that there is a policy for long-term development.

Mr. Hazell: On how many occasions over the past 13 years has the Price Review been agreed with the National Farmers' Union?

Mr. Peart: I gave examples for each year—

Hon. Members: Answer the question.

Mr. Peart: Five were disagreed in the last nine.

Mr. Scott-Hopkins: Perhaps the right hon. Gentleman will answer some of the questions that my right hon. Friend the Member for Rushcliffe (Sir M. Redmayne) put to him earlier. He asked whether the rise of ld. a gallon for milk will cover the increased costs that the dairy producer will have to meet.
Further, will the right hon. Gentleman tell the House whether these credit arrangements will mean cheap credit rates that he talked about during and before the election, or whether it will be an ordinary rate of interest from banking and other institutions.

Mr. Peart: The hon. Member has been in the Ministry of Agriculture and he knows there is a convention that the costs of particular commodities are not given. Costs affecting labour, and so forth, are given in the White Paper, but I am following the convention and I think it right to do so. It is hard to estimate an exact figure, and the hon. Member knows why.
On the question of credit, my proposal is to extend what was done under the Horticulture Act, and the hon. Gentleman knows what that was.

Mr. Emrys Hughes: Is my right hon. Friend aware that I represent more dairy farmers than the hon. Member for Nant-wich (Mr. Grant-Ferris) and that they produce better milk? Is he aware that recent rent increases in Scotland amount to as much as 3d. a gallon on milk, and that hon. Members opposite who wish to show sympathy with the farmer should set an example by reducing his rent?
Further, is my right hon. Friend aware that it is estimated by the "Farmer and Stock-breeder" that the farmers now owe £550 million to the banks in overdrafts, of which £56 million are owed by the farmers in Scotland? Will these agricultural facilities help to reduce the immense burden of interest rate that the banks now charge to the farmers?

Mr. Peart: My hon. Friend will appreciate that it was a Labour Government who first introduced, in 1948, legislation to protect the tenant farmer, and that it was a Conservative Administration, in 1958, who weighted instructions to the arbitrator as against the tenant farmer in relation to rents.

Mr. Bryant Godman Irvine: Can the right hon. Gentleman tell us whether the £11 million which he has mentioned in connection with dairy farmers is any real advance in the amount which they will get? Secondly, can the right hon. Gentleman say whether the industry, which, I think he said, has produced £29 million as a result of increased efficiency, is receiving an adequate reward for that effort in being allowed to have £10 million?

Mr. Peart: As I have continually explained, this is more generous than previous awards except for last year—much more generous. As I have said, on milk it is £11 plus, and this will help.

Several hon. Members: rose—

Mr. Speaker: We cannot deal fully with this matter by means of questions.

Mr. George Y. Mackie: On a point of order, Mr. Speaker. Is it in order that the Liberal Party should not be called, representing as we do very large agricultural areas?

Mr. Speaker: I am very sorry, but I cannot manage to ensure that all parties ask questions. This cannot be done. If the hon. Gentleman will look round he will see that it is manifest that we cannot hope to deal with this matter today.

Mr. Hooson: I appreciate your point, Mr. Speaker, that there are Members on both sides of the House who wish to speak, but, nevertheless, there are many members of the Conservative and Liberal Parties who represent agricultural constituencies and who have not been called. Further, we represent 3 million votes.

Mr. Speaker: That is an argument about how many votes various hon. Members represent. The point is that I am entitled to allow a few questions on a statement—just a few, nothing about parties or areas. Generosity in this matter, I am afraid, would be at the expense of other business. That is the trouble. I cannot even get round the map, let alone round the parties.

Captain Orr: Further to that point of order, Mr. Speaker. If at any time you should be giving consideration to the size of parties, would you remember that there are nine Liberals but there are 12 Ulster Unionists?

Mr. Speaker: And a large number of hon. Members representing Wales, and ex-Ministers and many hon. Members who are very interested in this subject. I am very sorry. I must ask for the sympathy of the House and request hon. Members to be sensible about this.

Oral Answers to Questions — BALLOT FOR NOTICES OF MOTIONS

Educational Television

Mr. Buchanan: I beg to give notice that on Friday, 2nd April, I shall call attention to the subject of a university of the air and educational television generally, and move a Resolution.

Cancer Research

Mr. Beaney: I beg to give notice that on Friday, 2nd April I shall call attention to the need for increased Government aid in research and public education in cancer, and move a Resolution.

Juvenile Delinquency

Mr. Buchanan: I beg to give notice, on behalf of my hon. Friend the Member for Derbyshire, South-East (Mr. Park), that on Friday, 2nd April, he will call attention to juvenile delinquency, and move a Resolution.

BUSINESS OF THE HOUSE (SUPPLY)

Ordered,
That this day Business other than the Business of Supply may be taken before Ten o'clock, and that if the first Resolution proposed shall have been agreed to by the Committee of Supply before half-past Nine o'clock, the Chairman shall proceed to put forthwith the Questions which he is directed to put at half-past Nine o'clock by paragraph (4) of Standing Order No. 18 (Business of Supply).—[Mr. Bowden.]

Orders of the Day — SUPPLY

[12TH ALLOTTED DAY]

Considered in Committee.

[Dr. HORACE KING in the Chair]

CIVIL ESTIMATES AND DEFENCE (CENTRAL) ESTIMATE, 1965–66, VOTE ON ACCOUNT; DEFENCE (ROYAL ORDNANCE FACTORIES) ESTIMATE, 1965–66; DEFENCE (ARMY) PURCHASING (REPAYMENT) SERVICES ESTIMATE, 1965–66; DEFENCE (AIR) ESTIMATES, 1965–66; CIVIL ESTIMATES, SUPPLEMENTARY ESTIMATES, 1964–65; DEFENCE (ROYAL ORDNANCE FACTORIES) SUPPLEMENTARY ESTIMATE, 1964–65; DEFENCE (AIR) SUPPLEMENTARY ESTIMATE, 1964–65; CIVIL ESTIMATES (EXCESSES), 1963–64

Orders of the Day — CIVIL ESTIMATES AND DEFENCE (CENTRAL) ESTIMATE, 1965–66

(VOTE ON ACCOUNT)

Motion made, and Question proposed,
That a sum, not exceeding £1,915,906,800, be granted to Her Majesty, on account, for or towards defraying the charges for the following Civil Departments and for Defence (Central) for the year ending on the 31st day of March, 1966:

CIVIL ESTIMATES


CLASS I



£


1. House of Lords
123,000


2. House of Commons
977,000


3. Treasury and Subordinate Departments
1,850,000


4. Department of Economic Affairs
399,000


5. Privy Council Office
20,000


6. Post Office Ministers
5,000


7. Customs and Excise
8,600,000


8. Inland Revenue
23,500,000


9 Exchequer and Audit Department
340,000


10. Civil Service Commission
324,000


11. Royal Commissions, etc.
200,000


CLASS II


1. Diplomatic Service
16,331,000


2. Foreign Services
9,184,000


3. British Council
1,850,000


4. Commonwealth Services
8,178,000


5. Colonial Office
2,800,000


6. Colonial Grants and Loans
7,000,000


7. Ministry of Overseas Development
800,000

Orders of the Day — NATIONAL HEALTH SERVICE (DOCTORS' PAY AND CONDITIONS

4.56 p.m.

Mr. Richard Wood: The House of Commons last discussed the present difficulties between the doctors and the Ministry of Health exactly a month ago, and I should like to congratulate both the right hon. Gentleman and the profession on losing no time after the debate on 17th February in entering negotiations.
I should like to repeat what I said at the beginning of the last debate—that I hope that nothing I say will make more difficult the task of the right hon. Gentleman. I sincerely believe that all of us would like to give him what help and support we can in his search for a solution of the present grave problem.
But I must say that it is exactly for this reason that I hope that he himself will say nothing which will make his own task more difficult. He was reported last week-end as having, denied that the remarks which he made the week-end before constituted any kind of attack on any section of the medical profession. Naturally we accept his disclaimer of any aggressive intentions and we are grateful for it, but the right hon. Gentleman will clearly realise that it is, unfortunately, impossible for remarks of this kind to be made without having any effect on an already difficult situation. Where feeling already runs deep, this is surely not the way to introduce a calm and reasonable climate for negotiation.
In other words, it does not make for the long, cool look which the Minister asked of the medical profession and it has already led to a number of comments far from cool, the most significant being the not very friendly remark of the right hon. Gentleman the Member for Loughborough (Mr. Cronin), who is reported as saying that the right hon. Gentleman was psychologically hostile to the medical profession.
I never quite know how to behave in these rather embarrassing quarrels in the party opposite, but, personally, in this fraternal tiff I find myself on the side of the right hon. Gentleman. I do not think that he is hostile, psychologically or otherwise, but the whole quarrel shows


only too clearly what happens in delicate situations when emotion is substituted for patience and common sense.
Earlier this month, the Prime Minister published a letter from the Review Body which contained what he described as the clarification of some points in its recent report. The effect of this was o remove, any conditions which were attached to the recent award. Several of my hon. Friends and my right hon. Friend the Member for Thirsk and Malton (Mr. Turton), during our last debate, expressed disquiet about the imposition of these conditions. My own view is that, however anxious any of us may be to see the introduction of a scheme where the amount of expenditure reimbursed bears a closer relationship to the money actually spent on ancillary help and practice premises—and Lord Kindersley makes no secret of his own feelings—it would be wrong to insist—and I believe that the right hon. Gentleman and his predecessor both undertook not to insist—on a particular method of distribution to which the profession is opposed.
I believe that the right hon. Gentleman, after seeming to take a rather different view a month ago, eventually showed wisdom in recognising this fact. But it remains the case that the question of reimbursing practice expenses has still to be resolved. This is, unfortunately, one of the many matters which still have to be decided.
On 8th March, the British Medical Association issued its "Charter for the Family Doctor Service". Discussion of it so far has turned mainly, but not exclusively, on the question of pay. I shall, therefore, begin by discussing this question, but it would be unfortunate, important as it is, if the problem of remuneration diverted attention from the wealth of other proposals in the charter.
One of the most important questions is the function of the Review Body in relation to the pay proposals of the charter. On the face of it, the present gap between the Minister and the profession seems to be wide. We have the B.M.A. saying:
… the detailed pricing of the new contract we have in mind must be first agreed direct between the Profession and the Government".
We had a statement from the right hon. Gentleman that
the entire question of how much the G.P. should be paid under the terms of the contract

must be left to the independent Review Body for consideration after the contract has been agreed.
If the Review Body were to be bypassed on this occasion, I would find it very difficult to look into the future and see it operating with authority in the years ahead. It seems to me that, wherever the immediate advantage may seem to lie, it is surely in the long-term interests of the medical profession that the prestige of the Review Body should remain high because the arguments which led the Royal Commission to propose it in 1960 and the considerations which inclined the profession towards this form of arbitration have certainly lost none of their cogency during the last five years.
It is important to remind ourselves of what the Royal Commission said:
We are satisfied that the appointment of such a body is the only means of achieving: (1) the settlement of remuneration without public dispute; (2) the provision of some assurance for the professions that their remuneration is not determined by considerations of political convenience; (3) the provision of some safeguard for the community as a whole against medical or dental earnings rising higher than they should".
It may be that some of us would feel that the first objective—the settlement of remuneration without public dispute—may today have a rather optimistic ring about it, but I think that most of us are certain that, on the whole, all these desirable objectives would be very much more difficult to achieve if the authority of the review body were damaged by its exclusion from the present negotiations.
I therefore hope that the B.M.A. will not be too ready to dispense with arbitration in this present dispute, because I believe that by doing so it would almost certainly destroy the effectiveness of that arbitration in the years to come.
I come to the other proposals in the charter. I think that the House as a whole is anxiously awaiting the comments of the Minister on those proposals. He was kind enough, before the debate began, to let me have a copy of his letter to the General Medical Services Council, which we shall certainly study with interest and which, no doubt, he will want to amplify publicly during the debate for the benefit of the House.
We have been assuming that he would give a warm welcome to the many constructive suggestions contained in the


charter for such things as the greater availability of diagnostic aids, more ancillary help, the improvement of premises, adequate numbers of G.P. beds, and so on. We hope that he is already discussing some of the proposals, particularly, perhaps, the one about certification and the burden which it places on doctors, with the Minister of Pensions and National Insurance to see in what way this very general widespread burden could be lightened.
I shall be asking the right hon. Gentleman very shortly some questions both about group practice and the supply of doctors, but meanwhile I doubt whether any of us would quarrel in principle with the need to provide family doctors with reasonable leisure, although, as I will try to show, I believe that the charter's proposals on this subject seem to take us to the very heart of the doctors' dilemma. The question which faces all of us, and doctors in particular, is: what should be the shape of general practice in future?
The charter contains the statement that
General Practice must remain a personal family service.
I am sure that we should all like to see it remain so. Although other hon. Members may disagree with me, I believe that the personal nature of this service could be preserved even if doctors were to look more to the State for the provision and modernisation of premises. But I am much less sure whether it could for long survive the introduction of regular working hours and payments for overtime. One newspaper last week drew attention to the simultaneous wish of the doctors for the independence and status of self-employed professional men and for the limited hours and overtime rates normally expected only by salaried employees. There is a real dilemma here.
It is perhaps very easy for us to talk. Most of us here are fortunate enough to enjoy reasonable leisure, and, except for a few rather miserable occasions during the year, we generally have undisturbed nights. For that reason, it would be wrong for us to try to deny what we enjoy to the doctors. It would certainly be shortsighted, because the potential contribution of overworked general practitioners must be seriously and, perhaps, dangerously devalued. Nevertheless, if the family doctor service is to survive in a

recognisable form, there are certain features peculiar to it which cannot be ignored.
Most patients, for instance, have the inconvenient habit of preferring to see their personal family doctor rather than any other doctor who happens to be on the rota on any particular day. If they continually saw the rota doctor, they might begin to fail to recognise the personal service which we all want to preserve. In the more populated areas it is perhaps through group practices or partnerships that an increasingly acceptable compromise might be offered. Patients there frequently get their own particular doctor, but, meanwhile, they come to know the other partners whom they accept with a greater or lesser degree of willingness when their doctor is off duty.
Yet I find it remarkable that, in spite of the real contribution which group practices or partnerships are making, and could make, about a quarter of our general practitioners still work either single-handed or in partnership with one other doctor. Real problems will continue to exist in some of the rural areas.
I should, therefore, like to ask—and I think the Charter asks as well—what are the right hon. Gentleman's present proposals to encourage group practice? In the last debate that we had on this subject in the last Parliament he said:
The Government must accept responsibility for providing premises for group practice. A system of loans must be replaced by one of grants. That is what a Labour Governmnt would be prepared to do."—[OFFICIAL REPORT, 27th July, 1964, Vol. 699, c. 1017.]
Now, less than eight months later, are the Labour Government still prepared to do that?
Can the right hon. Gentleman, at the same time, take us further on another promise that was made before the election, the promise to set in hand an increase in the supply of doctors? Last year, again in the debate to which I have referred, the right hon. Gentleman told us that a Labour Government would ensure the setting up of four new medical schools at least. During the debate a month ago I asked whether he had persuaded his right hon. Friend the Chancellor of the Exchequer to provide money not only for the promised new medical schools, but for the expansion of places in the existing schools.
On that occasion he gave no answer, but his right hon. Friend the Secretary of State for Education and Science gave us a flicker of hope last Thursday, when he said:
This matter is under consideration, but I am not yet in a position to make a statement."—[OFFICIAL REPORT, 11th March, 1965; Vol. 708, c. 128.]
When can we expect a statement on this most important matter, and is it too optimistic to hope that this election promise will be fulfilled within the span of this Parliament? We should like the right hon. Gentleman not to forget, if he would be so kind, to give us an answer to that question, because I believe it to be fundamental to the problems that we are discussing.
During the debate last month a certain amount of attention was paid to new methods of remuneration. Just as I had mastered the intricacies of the old pool system, it seems to be near the point of death, and I have not heard a single lament in its honour, and now a vast question mark stands over the system, or systems, of remuneration which are to operate in the future.
The charter suggests that doctors should be given the choice between three methods of payment—capitation fees as at present, item of service, or some form of salary. It seems to me that all these methods have both advantages and disadvantages. The capitation fee gives to the doctor a definite incentive to take on patients although, in its naked form, it makes no allowance for their differing demands. But, to take account of the extra attention which is needed by the old and very young, I suppose that it may be possible to adjust the capitation fee method by a suitable system of weight for age.
Then there is payment by item of service. This would overcome the particular difficulty I last mentioned, but it is clear that many of the services which a doctor performs for his patients are extremely difficult to itemise. It is true that dentists are paid in this way, but I doubt whether itemisation in dentistry presents exactly comparable problems. In the case of doctors, much would have to be covered by the term "consultation", and I would find it hard—and I would be grateful if the right hon. Gentleman would give us his views about

this—to decide what the proper reward should be for a long and intricate consultation on the one side, and for a very simple consultation of a few minutes on the other.
The third method, that of a straight salary, would certainly get over many of these problems, but I have no doubt whatsoever that it would produce a great many new ones of its own. Among others, this method of a straight salary raises the most profound and important question whether the personal nature of the service could continue if the present relationship between the patient and his or her doctor ceased to exist.
I think that it would be unwise for any of us, certainly for me, to be dogmatic about any of these different forms of payment. It may be that the right hon. Gentleman has it in mind to experiment with one or more of them. In the case of an experiment with the salaried system, I would be grateful if the right hon. Gentleman would confirm that this would need an amendment to the 1949 Act, because one of the main objects of that Act was to prevent a State salaried medical service being introduced by means of regulation alone.
If I am right in thinking that that experiment could not be introduced without amending legislation, we should naturally examine very carefully any Bill which the right hon. Gentleman introduced, but we should not oppose in principle an experiment with any of the methods which general practitioners believe might be a suitable system of remuneration. We should certainly want to study the results of the experiments, and I assume—and perhaps the right hon. Gentleman will confirm this—that if the experiments were carried out they would take place in different parts of the country in order to take account of widely differing circumstances.
The Charter is rightly and naturally concerned with the status of general practitioners and their proper place in the Health Service of the future. I am concerned, as I imagine and suppose we all are, that the key position of the general practitioner in the Service should not only be recognised, but that it should be made possible for him to occupy it.
The Health Service is "tripartite" in more senses than one. It is not only


a unity between the medical services, the hospital services, and the local authority services. It is, or should be, as I see it, a co-operative enterprise between the Government, who determine its structure, everyone, whether skilled or unskilled, who works within the Service, and everyone who benefits from it. All these three, the Government, the doctors who work inside the Health Service, and the patients, have their responsibilities for its success.
The responsibility of the Government, and the right hon. Gentleman in particular, to improve the framework and conditions of the Service is only too clear, and I assume that the right hon. Gentleman willingly accepts that responsibility. The responsibilities of general practitioners, whatever the result of the present negotiations, are bound to remain immense, and, if we spend the time in thinking about them, literally terrifying in their implications. In this House and else-where we are sometimes afraid to talk about the responsibilities of patients, but I believe them to be very real, and I believe that they must be recognised if the Health Service is to survive.
These three partners share the responsibility for the relationship which exists, and will continue to exist, between the patient and his doctor, and it is on that relationship that the whole position and status of general practitioners, both in the Health Service and, I think, in society as well, ultimately depends. We want, today, undertakings from the Government about the ways in which the right hon. Gentleman proposes to discharge his share of this joint responsibility.
With regard to the responsibility of patients, I believe that it is essential that all of us—after all, we are all patients or potential patients—should arrive at a real understanding of, and sympathy with, the problems of doctors—in particular, the appalling difficulty for doctors, who are sometimes almost worn out with work and frustration, to realise how much individual men, women, or children are in need of the care which only they can give. But it is the doctors, finally, who will really determine the kind of relationship that is to exist in the future between them and their patients. I believe that it would be extremely unwise for us to try to hide our heads in the sand.
I believe that today there is a real threat to the relationship between doctors and patients. If that relationship were seriously damaged we would all be the losers, and it is possible that general practitioners would lose most heavily. This is why I believe it to be essential, even if the form and circumstances of the relationship between doctors and patients undergo a change in the future, for the personal nature of this relationship to be held to as long as is conceivably possible.
It is true to say that the Health Service could undergo all kinds of changes and modifications and still preserve its continuity and character, but if we destroy or damage the personal relationship between doctors and patients, which seems to me to lie at the very heart of the Health Service, we may be left with something that went by the name of a National Health Service, but I doubt whether it would be easily recognisable.

5.20 p.m.

The Minister of Health (Mr. Kenneth Robinson): I welcome the debate. At the outset, I want once again to express my appreciation at the consistently helpful and constructive tone of the speech of the right hon. Gentleman the Member for Bridlington (Mr. Wood). I was especially glad to hear his observations about the Review Body. I hope that these will be pondered by those who are making decisions elsewhere in this con-nection. As I expected, the right hon. Gentleman devoted the greater part of his speech to the problems of general practice and the situation which the profession and the Government are facing at the moment. I propose to do likewise.
There are one or two points which are slightly extraneous to that, however, but I want to get out of the way at the outset. I was not surprised when the right hon. Gentleman made a brief reference to some remarks that I made about one or two surgeons in a speech about ten days ago. At this stage I will not add to the later speech that I made at Nottingham last Saturday, which the right hon. Gentleman described as a disclaimer. I made my position and intention clear in that speech, and in leaving the matter there I hope that I am responding to the right hon. Gentleman's suggestion that I should say nothing this afternoon which might exacerbate what


we all agree remains a delicate situation in respect of general practitioners.
The right hon. Gentleman also asked about medical schools. I recall that in opposition I said that we needed four new medical schools, and not merely the one which was planned and announced by the Government of which the right hon. Gentleman was a member. Responsibility in the departmental sense, as the right hon. Gentleman knows, rests with my right hon. Friend the Secretary of State for Education and Science, although I am vitally interested in this matter, since we must have the doctors to run the National Health Service.
The supply of doctors can be expanded most rapidly by increasing the intake of students into the existing medical schools. That has been done to the extent of a 25 per cent. increase within the last four years. I am told that any substantial further increase into existing schools will need additional facilities at the schools, and these requirements are being urgently examined. The planning of the new medical school in Nottingham is going ahead, and longer-term needs, such as the possibility of future new schools, are also under urgent consideration. I cannot give a time when my right hon. Friend or I shall be able to make a statement; I can only assure the right hon. Gentleman that we are seized of the urgency of this matter, and that there will be no avoidable delay in communicating our conclusions to the House.
I now turn to the main part of the right hon. Gentleman's speech. His questions on the charter and on general practice in general will be answered in the course of my speech. He will forgive me at this stage if I cannot answer in detail questions which he may have posed and which will come up for discussion in the negotiations which we hope will start. It is a mark of the importance and urgency of the problems that we are facing that we should debate them in the House on 17th March as well as 17th February.
I have only one complaint to make about the Opposition—the timing of these debates. We all like to think that what is said is debates here may have an influence on what is going on elsewhere. It so happens that the debate on 17th February took place on the very day of the meeting of the Council of the British

Medical Association, which was considering the Review Body award. Again, today, the debate is taking place on the very day when both the General Medical Services Committee and the Council of the B.M.A. are considering my response to the charter. Our chances of influencing those bodies by what is said in the House today are minimal.
I can probably best serve the Committee by tracing as briefly as I can the course of events since the February debate. In so doing I may have to run over some of the ground covered by the right hon. Gentleman. On that occasion the Review Body's recommendations that doctors' remuneration should be increased by £5frac;12 million a year, and also that the bulk of the money should be used to facilitate the schemes for fairer distribution of practice expenses, were under consideration by the Council of the B.M.A.
The Council apparently recorded neither acceptance nor rejection of the recommendations at that stage, but it endorsed the resolution of the General Medical Services Committee that doctors should be asked to send in undated resignations from the Health Service and that there should be immediate negotiation with me on a new contract and new methods of remuneration. It went on to say that as an essential preliminary to the negotiations the £5½ million increase should be used not as the Review Body had recommended but for an all-round increase in capitation fees, leaving the present distribution of practice expenses unchanged.
The Government had accepted the Review Body's recommendations in their entirety, and it was not easy to see how the deadlock which was thus created could be broken. But later in the week the leaders of the profession came to see me in order to discuss the situation. I made it plain at the meeting—as I had to—that I could not agree to make the £5½ million available for a general increase of pay in breach of the recommendation of the Review Body. However, after some hours of discussion it became clear that in the profession's present mood the practice expenses scheme was no longer acceptable to it. I therefore agreed to transmit to the Review Body the profession's request for clarification of the Review Body's intentions regarding the £51 million in the event of the practice


expenses scheme not being agreed to by the professison.
The Review Body considered this request a few days later—and here I want to pay my tribute to it for the speed with which it dealt with this matter. It indicated that although, in such an event, its recommendation for the distribution of the money could not be implemented, its other recommendations would nevertheless stand. The Government adhered to their acceptance of these recommendations, and, as a result, the £54 million will be added to the pool for 1965–66.
It appeared to be the view of the profession that the money should all go in general distribution. Since I could not introduce a practice expenses scheme against its wishes, the Government have agreed to this. I did not conceal my regret at the loss of this opportunity at any rate to make a start with a fairer distribution of practice expenses in a scheme which everybody—the Government, the profession, as I think, and the Review Body—agree is so desirable in the interests of good family doctoring.
I have heard what has been called the untying of the strings of the £5½ million described as a victory for the doctors. It is hard for a Minister of Health to see as a victory for anyone an outcome which frustrates, even though only for the time being, progress in a direction which all agree is the right direction. However that may be, the way now seemed clear for discussion on the new contract and new methods of remuneration. As I told the House in the debate on 17th February—hon. Members may refer to column 1217–8 of the OFFICIAL REPORT—I have always been willing to discuss these matters, but the profession's representatives did not feel able to do so until the business of the £5½ million had been settled and was out of the way.
Even so, the British Medical Guild—which is, of course, the Council of the B.M.A. with different hats on—sent out letter after letter to family doctors urging them to submit their undated resignations, with fresh forms to fill in in case they had mislaid the first lot. The B.M.A. Council also summoned a meeting of doctors from all over the country for 24th March, a week today. It announced that unless this meeting decided to the contrary, in the light of progress in dis-

cussions with me the resignations should go in, presumably on 1st April. I refrained from any comment on these activities, apart from the point I made earlier that I could not continue negotiations if the resignations were actually sent in.
The profession did not open discussions with me immediately. First six doctors were instructed to prepare draft proposals. After a 48-hour conclave they produced a document for presentation to me as the profession's proposals for far-reaching changes in a system that had been in operation for nearly 17 years and really, in basic principle, for about 35 years before that. It was, of course, a formidable task that they had set themselves. There was a great deal of material to work on, from publications over the years, including the material collected by the B.M.A. for presentation to the Working Party on General Practice which my predecessor set up. It was, none the less, a tremendous task to produce a set of firm proposals in a couple of days when for years the profession had been unable to agree on what the answers should be.

Dr. Wyndham Davies: Would not the Minister agree that this charter which he is claiming was produced in 48 hours has been largely the policy of the Medical Practitioners' Union over a number of years and this was stated by the Medical Practitioners' Union, which has several influential members on the benches opposite, at a recent meeting in the House?

Mr. Robinson: I certainly should not like to intervene in what may possibly be a disagreement between different bodies representing the profession. I very much doubt whether the B.M.A. would endorse the intervention of the hon. Gentleman
However, I was saying that it was a tremendous task, and one cannot altogether stifle doubts whether six doctors have necessarily hit on the best structure for general practice and the right way to secure it. For example, little is said about group practice, to which the right hon. Member for Bridlington devoted part of his speech, and about which I have spoken very often in this House. Experience has, I think, amply confirmed the value of


group practice in removing frustrations and in providing infinitely better working conditions for the doctor. What I should like to do is to bring about a situation in which more doctors will combine voluntarily in groups that match local needs, with due regard to what the hospitals and local authorities are providing, and planning to provide, and indeed with help for the general practitioners from local authority staffs. Obviously, for this purpose there will have to be joint studies of local needs. I should like very much to encourage this in any way I can.
I realise that the question of how premises are provided is important in this context. I have already indicated to the profession that I accept the need to help doctors with the provision of finance for this purpose.

Mr. Wood: The right hon. Gentleman in the debate last July made a categorical statement that he intended that the future Labour Government would substitute grants for loans. Is that still his policy?

Mr. Robinson: This, in fact, is a matter which comes within the discussions which I shall have. The right hon. Gentleman will have seen from the charter that the profession's representatives have other ideas about financing practice premises. I want to go into these discussions with an open mind. I shall be putting ideas of mine and they will be putting ideas of theirs. I do not want to lay down a fixed policy at this stage.
The document, the family doctor's charter, reached me officially on Monday, 8th March. I did, in fact, receive an advance personal copy of it at the weekend. This, as I think the House will see, left me little more than a week to express my views on it if these were to be considered by the General Medical Services Committee and the Council in time for the meeting on 24th March—next Wednesday.
There were two factors in the document about which I must confess I felt some disappointment. First, that so little emphasis was placed on what has always seemed to me to be the central problem of general practice, the method of organisation of the service and, secondly, that so much emphasis was placed on the cash price of the general

practitioner's services. Certainly the G. P. s must be fairly rewarded, but I have always made clear that while I am prepared to discuss anything else with the profession, the quantum of remuneration is a matter for the advice of the independent review body appointed for the purpose. I think that no one could have misunderstood what I said in the House on 17th February—it is reported in column 1281 of the OFFICIAL REPORT, if anyone wishes to refer to it—and I was disturbed that the profession should have paid so little regard to this aspect.
The document was actually published on Monday, 8th March, the same day as I officially received it. Criticism of it in the Press was concentrated on, but not limited to, the size of the pay claim embodied in it. The Secretary of the B.M.A. held a Press conference and appeared on radio and television to expound the proposals with estimates of the cost. He told the public that it was now up to the Minister to make up his mind on the proposals and thus to determine the issue whether the profession would resign.
Again, quite deliberately I refrained from any public statement or any appearance on T.V. or radio until I had had an opportunity to meet the profession for a first exchange of views. That meeting took place on 12th March and afterwards I gave the Press, not an account of the meeting, which at that point had been adjourned until the next day, but my own first reactions to the charter, just as I have conveyed them to the profession.

Lord Balniel: In order to clarify this matter, may I say that I think the right hon. Gentleman said that the first public comment he made on the charter was on 12th March. Am I wrong in thinking that he held a Press conference on 10th March?

Mr. Robinson: As soon as I said 12th March I thought that I had got the date wrong. The noble Lord is quite right, it was Wednesday, 10th March. The document was published on Monday, 8th March. I said nothing about it until I had seen the profession on the morning of the 10th and the Press conference followed my first meeting with the profession. I am grateful for the correction.
I held this conference and told the Press, just as I had told the doctors, that the charter seemed to me to provide the framework for negotiations on the contract and on methods of remuneration, and that I was ready to help with the provision of premises, but quantum should be considered by the Review Body. I said that only actual handing in of the resignations collected could frustrate progress.
The Press, I think very correctly, reported my tone as "conciliatory" and that was certainly my intention. I am sorry that the B.M.A. saw fit to issue in quick succession two strongly worded statements charging me with being inflammatory and tendentious; inflammatory because I reminded everybody that I could not negotiate under duress—the House should remember that the British Medical Guild has not felt inhibited about continuing throughout to urge on doctors the sending in of resignations—and tendentious because of the figures I have quoted. These statements were understandably seized on by the Press as a dramatic clash between the Minister and the profession.
Perhaps I could say a word here about the figures. In view of the profession's attack on my Department's estimates, I suggested that the best course was for the experts on the pool on both sides who had worked out the estimates to get together and either agree on what was a fair assessment of the cost or at any rate to define the area of disagreement and the reasons for any disagreement. This procedure was agreed at a meeting with the profession's negotiators the following day, 11th March. I am glad to say that the experts have now agreed on a rough estimate of the increased remuneration implicit in the charter. It is £40½ million, or £35 million over and above the £5½ million recommended by the Review Body. For a given volume of expenses, these are net figures. They relate to about 22,300 doctors, and the arithmetical average per doctor is thus over £1,800 per doctor, or over £1,550 on top of the recent Review Body increase.
The profession took me to task for mentioning an average of £1,800 a doctor. They had suggested a figure of £900 because, so I understand, this was all

the increase which they thought would be guaranteed under the charter to a doctor with an average list, whose income derived entirely from capitation fees, in other words, a doctor who was not getting remuneration from weekend work or overtime payments or any of the other things which are outside the capitation fee.
I thought that this was a difficult argument to follow. To me, the average per doctor is the total increase divided by the number of doctors. If there is a large number who would get only an extra £900, there must be many who would get very much larger increases than £1,800. This follows, I think. I know of no way of giving an overall picture except by an arithmetical average. I cannot agree that to quote such an average was in any way misleading. However, I am glad that the B.M.A. and I are now agreed on the global cost of the proposals. Certainly, it is beyond dispute that the charter, as priced by its compilers, implies a very big increase in remuneration for the family doctors. Nevertheless, I have not rejected it out of hand on that account.
There is much in it which seems to offer hope of agreement on changes which will improve general practice and the lot of general practitioners without any necessary implication for amount of remuneration. I want to negotiate on these matters. On quantum, I find it a little ironic that the profession are now pressing for direct negotiation with the Government. The history of the National Health Service has been punctuated with bitter disputes between Government and profession on remuneration, disputes which have had to be resolved in each case by recourse to independent advice, first Mr. Justice Danckwerts in, I think, 1951, then the Royal Commission 1957–60, then the Review Body. The Review Body was set up on the Royal Commission's recommendation and in accordance with a suggestion from the doctors themselves. The right hon. Gentleman quoted from the Royal Commission's Report; let me quote from another part of the Report. In paragraphs 402 and 403, it said:
We have no doubt that some arrangements should be made to keep remuneration under review, and that they should be such as to achieve three aims which we consider to be of great importance.


The first is that avoidance of the recurrent disputes about remuneration which have bedevilled relations between the medical and dental professions and the Government for many years. Whatever the rights or wrongs of these disputes, they do nothing to promote the smooth working of the National Health Service.
I was going on to quote paragraph 429, but the precise words, which are relevant in this context, have already been quoted by the right hon. Gentleman, so I shall not weary the House.
The Review Body was set up with the professions' agreement and steps were taken to make sure that its membership was such as to command their confidence. They expressed that confidence in unequivocal terms only three months ago in the letter which I quoted in the debate on 17th February. To the Government it is inconceivable that this source of advice on general practitioners' remuneration should be ignored in so important an operation as the pricing of a new contract. My right hon. Friend the Secretary of State for Scotland and I note that the profession now wants direct negotiation with us on remuneration, but we must be forgiven if, in the light of history and of happenings in recent months, we have our doubts about the prospects for a satisfactory outcome from such negotiations. I would think that, on reflection, the profession itself might share those doubts.
But I do not want to dwell on the negative side of my response to the charter, particularly as this concerns an aspect which, I made it clear in advance, I could not discuss. On what I understood the charter was going to be about—a new type of contract and new methods of remuneration—I am entirely ready to negotiate within the framework put forward, with a view to the first fundamental change in the structure of general practice in the whole 17 years of the National Health Service. Even on the pricing of the contract, I would have said that willingness to refer to independent advisers is not usually regarded as an unco-operative or oppressive attitude to adopt. Altogether, I cannot see how I could have been more conciliatory in my response to proposals put forward in the circumstances which I have described. I was called upon to commit the Government,

at very short notice on proposals to which the profession are not yet committed at all—I should like to emphasise this—and to declare my position before actual negotiations could even start. But because I understand the profession's difficulties and because I am genuinely concerned for the future of general practice, I have not allowed this to deter me from responding positively on all the main points except quantum.
Perhaps I might read to the House one or two paragraphs from the letter which I have sent to the chairman of the profession's negotiating committee.
I shall not weary the House with the whole letter, because it is a long one, but it says in part:
It has been repeatedly stated that what is now needed in general practice more than anything else is a revision of general practitioners' terms of service and methods of remuneration. I have told you that your proposals for a new type of contract and flexibility in methods of remuneration seem to me to provide a perfectly possible framework for negotiation. During the course of negotiation I shall want to inject ideas of my own, but I believe that the Charter offers an opportunity, which we should all do well to seize, to improve the general practitioner service for doctor and patient alike.
I was at first concerned lest the proposal for limited liability for the individual doctor and a review of the Allocation Scheme implied a repudiation of the liability of the profession as a whole for the general medical care of the population as a whole, with continuous cover, but you have assured me that this is not so, subject to reasonable protection of the individual doctor against unreasonable demands on his services. On this basis I am prepared to discuss limitation of individual liability.
Then I go on to deal with the Review Body point, and a little further I write:
My position is that, provided it is understood that I should not be ready to agree to new levels of remuneration except on the recommendation of the Review Body I am prepared to negotiate on all the other matters covered by the Charter, and I believe that it would be in everyone's interest that we should do so.
One of the suggestions in the Charter, for example, is that public finance should be made available for the provision of practice premises. I am interested in any idea likely to improve general practice and I shall be very ready to consider with the profession how premises for practice can be provided in a manner most likely to bring maximum benefit to doctors and patients alike. I accept the need to help doctors with the provision of finance for practice premises, and I am prepared to discuss with you your particular suggestion for a separate publicly financed corporation, though,


as I have explained to you, this would require legislation.
My final paragraph reads:
These discussions are bound to take time, notwithstanding everyone's best endeavours, and I do not see how new arrangements could in any event be brought into effect before the end of the period for which the Review Body's recommendations in 1963 were intended to last.
Broadly, that is, 1st April, 1966, which is just over 12 months from now. I continue:
With good will on both sides I should hope we could have a new and priced contract ready to introduce then. Our joint aim must be to secure for the general practitioner the conditions he requires to give the best care to his patients and the greatest satisfaction to himself.
That is the end of the letter.
The right hon. Gentleman asked me about legislation. I have already mentioned one point of the charter which, in my view, would involve legislation, and I agree with him that the introduction of a salaried general practitioner service would also involve amending legislation in the light of the Section in the 1949 Act. I have quoted from the letter at some length, and I understand that copies of it are now available in the Vote Office. If, as I hope, the profession decide that negotiation is the wiser course, I do not want to pretend that the negotiations will be short or easy. We shall not want to delay them in any way, but they are bound to be long because they cover a very wide area—the whole field, in fact, of general practitioner work.
We shall want to be sure that the changes which we shall be making together—changes which will determine the future of general practice in this country—are the right ones. Negotiation is likely at times, perhaps, to be tough, for it would be unrealistic to expect an identity of view on all, or even perhaps most, of the problems which are bound to come up. But on both sides of the table, I hope, there will be a common interest, because the welfare of the patient, I am sure, will be in our minds throughout. Provided that this is so, I believe that we can achieve a satisfactory conclusion.
It would be miraculous, however, if we could reach the right answer for all time to every question, and what I profoundly hope is that we should not allow any new structure of general practice to

ossify, as the 1948 pattern has been allowed to do, causing growing frustration and worry for doctors and often a second-best service for patients. For my part, I should be willing to keep the pattern which emerges under periodical review and to consider with the profession what changes may be needed from time to time to improve it.

Mr. A. Woodburn: As my right hon. Friend has so far described these arrangements, it seems that the negotiations will be fairly narrowly confined to what is in the charter. My understanding is that a very large number of younger doctors would like to see some experiment, some pilot scheme, of a salaried service, connected with health centres, as has been the ideal of the profession for many years. Would it be possible for this to be discussed within these arrangements?

Mr. Robinson: Yes. I can assure my right hon. Friend that I have already told them—I think that I said this in my spech—that I should have ideas of my own which I should want to inject into the discussion. There is no difficulty at the moment about the provision of health centres from the legislative point of view. Local authorities are willing to build them and doctors are willing to work through them. As for the point about a salaried service, my right hon. Friend will be as glad as I am that this is now a subject which the profession itself has said that it wishes to discuss. Of course, it is anybody's guess how many doctors would prefer to be salaried, but there is no doubt that quite a substantial proportion of doctors today would prefer to be on a salary. Certainly we can discuss this matter.

Mr. Frederic Harris: Is the Minister saying that, apart from the injection of £5½ million, in his opinion there cannot be any further pay adjustment of any kind until April 1966? Is that what he means?

Mr. Robinson: No. What I have said is that I envisage these discussions as being, first of all, discussions direct with me about the terms of the contract—a completely new form of contract—and methods of remuneration. Only when that stage is completed can the Review Body be asked to do its task of, so to speak,


setting a price or, if hon. Members prefer, a schedule of prices on what has been agreed. As I said in my letter, and as I have told the profession, taking into account that legislation is also needed, the whole of this operation is likely to take the best part of 12 months. That will take us to about the end of the period for which the Review Body have said the 1963 settlement might be intended to last.

Mr. Harris: Could the award be backdated?

Mr. Robinson: This would be a matter for the Review Body. I have told the profession very many times that I do not want to discuss quantum in any sense at this time for the reasons which I have given, and I must tell the hon. Member the same thing.
There can now be, in my view at least, no conceivable excuse for withdrawal from the service. I cannot think that, in the light of my expressed willingness to negotiate, family doctors will wish to persist in a course which could only amount to, and would be seen by the public as an attempt at, coercion of the Government. Though doctors rightly stand high in public esteem, I do not believe that a doctors' strike—and however much the doctors dislike that word, this is how it would appear to ordinary people—would gain any sympathy or support from the public at large. Because, let us face it, it would be a strike about pay and not about working conditions or the structure of the family doctor service or any of the other matters which I am ready to discuss.
The National Health Service, whatever its defects may be and we can always argue about those—has become part of the British way of life. It is recognised, I think, by all political parties as permanent, and in my view it represents the civilised way of organising medical care. After 17 years' experience of this great service, I think that the people of Britain would not take kindly to any attempt to force them to become private patients.
I could say very much more about the unavoidable consequences both to the doctor and to the patient of mass withdrawal, but I shall refrain because I cannot see such an action as a rational

possibility in the light of the Government's initial response to the family doctors' charter. Nor, for the same reason, will I say anything about any plans which I may have to deal with such a contingency. I prefer to believe that commonsense will prevail and that it will not come about.

6.0 p.m.

Colonel Sir Malcolm Stoddart-Scott: All hon. Members will feel that the Minister made a most friendly and conciliatory speech, certainly more friendly and conciliatory than his last speech. He rightly showed that he feels real concern for the welfare of the patient and the welfare of the doctor. I hope that before the profession takes any action which has been threatened its members will read and reread the right hon. Gentleman's speech, which showed great hopes of a satisfactory settlement.
The crisis which has arisen is really a manpower crisis. It is not only in the general practitioner service, but in our hospitals, and some people who know better than I believe that it is greater in the hospitals. We have 4,000 Indians and Pakistanis helping to run our hospitals. At the same time, 400 United Kingdom doctors leave this country annually. The Minister will correct me if I am wrong, but I understand that last year, for the first time, the number of doctors in the general practitioner service diminished—and diminished by 70. That is a serious thing. It means that for the first time we have had a running down of the medical manpower in the general practioner service. We must seek ways of putting this right.
I believe that one of the main causes of this were the recommendations of the Willink Committee and that the members of that Committee arrived at the wrongest conclusion it was possible for them to reach on the facts laid before them. If it were possible, I would like the Minister to call that Committee together again—the members of it who are still alive—and ask them to have a look at the situation to ensure that we do not go wrong again, for this could be the beginning of a real drain of manpower in our medical services.
This shortage has thrown an increased load on our general practitioners and we must realise that, with a diminishing


number of them and an increasing population, a tremendous increase in the load has been thrown on the medical profession. Not only is the birth rate increasing annually, but people are living to a greater age. These things are throwing an extra burden on the general practitioner service.
I believe that this burden will increase and not diminish. If one looks 10 years ahead one can see that the number of people between 65 and 80 years of age will have increased tremendously. This will mean an added burden on a diminishing general practitioner service. We must, therefore, consider, first, how to retain the general practitioners we have and the doctors in our hospitals and, secondly, how to increase their numbers. I was delighted to hear the Minister say that a new medical school is in the process of formation at Nottingham.

Mr. K. Robinson: Perhaps I should not try to take credit for the Nottingham Medical School. Its establishment was decided by the previous Government.

Sir M. Stoddart-Scott: If the right hon. Gentleman looks through the dusty files in his Ministry he will find a memorandum which I laid in 1948 recommending the setting up of a medical school in the City of Bradford, the largest centre of population in the country, which in those days did not have a university. At the end of this year it will have a university, the first chancellor of which will be the present Prime Minister. I suggest that this centre of population would be a suitable place—considering the splendid hospital, which is well staffed—for the establishment of a new medical school.
One must realise that the provision of new medical schools, including the one at Nottingham—and I hope that another will be recommended for establishment in the City of Bradford—will not produce any extra manpower for our medical services for at least eight, and probably 10, years. We must, therefore, consider how we can retain the doctors we already have. What can we do to reduce the workload to prevent 400 doctors yearly leaving this country? We can do much by providing ancillary staff, modernising equipment, providing adequate premises and preventing the wasting of time, as my right hon. Friend suggested, in signing many hundreds of certificates.
I must add—although I realise that hon. Members opposite will not like to hear this—that the removal of prescription charges has added greatly to the doctors' burden. Doctors have had to make out 30 per cent. more prescriptions, and when one realises that each prescription represents a consultation or interview, it is a large increase. In the City of Bradford the additional number of prescriptions has been 50 per cent. I believe that I see the Minister shaking his head in disagreement. Perhaps I might also inform him that the cost of this concession, which was stated by the present Government to have been estimated at £26 million, will be nearer £40 million.

Dr. David Kerr: We acknowledge that the number of prescriptions has increased, as they always do in February. Perhaps the hon. and gallant Gentleman could say what is the present rate of prescribing compared with previous years, when the prescription charge was on.

Sir M. Stoddart-Scott: The prescribing rate compared with the previous February is up by 30 per cent. over the country as a whole and by 50 per cent. in Bradford.

Mr. Robinson: Would the hon. and gallant Gentleman tell me from where he gets his figures, since there are certainly no official figures available here?

Sir M. Stoddart-Scott: I will drop the Minister a note and inform him.
While the Minister was talking about the increase in the cost of the recommendations in the charter—of —35 million, not taking, into consideration the £5½ million—I thought that he should also be taking into account the additional amount as a result of abolishing prescription charges which, as I say, may be £40 million and not £26 million, the figure which he gave the House three months ago.
If we are to retain the doctors we have we must see that their working day and week is less Victorian than it is at present. Many doctors work seven days a week, many more six days. Many work 10 to 12 hours a day. There is no other profession in which people work so hard and long. We must get this work load reduced by some means or other and the working week fixed at six days at the most, and eight hours a day.
I appreciate that group practice will be one way and I was glad to hear my


right hon. Friend and the Minister speak so highly of the importance of group practice. However, it is not possible in the most rural areas to go in for group practice. So we must consider those doctors who practise in the very rural areas and find ways to reduce the work load on them.
Would the Minister confirm that doctors do a lot of work for which they are not paid? For example, when doctors in the Health Service emigrate, and their places are not filled, their work must be done by doctors in neighbouring or surrounding districts. If a doctor doing this work has more than 3,000 people on his panel I understand that he does not receive any extra pay for the extra work he does.

Mr. K. Robinson: The maximum figure is 3,500.

Sir M. Stoddart-Scott: So it is possible that a doctor who takes on extra work and more patients—simply because a nearby doctor has emigrated or his practice has not been filled—does work and does not receive pay for doing it. I hope that the right hon. Gentleman will look into this to ensure that doctors get paid for every bit of work they do.
At the moment, they are grossly underpaid. Over the last 13 years their remuneration has increased by 40 per cent., but in that same period the cost of living has gone up by 50 per cent. and salaries and wages have gone up by 110 per cent. The doctor is at the very end of the queue—others have had salary and wage increases amounting to almost three times as much as his.
The Minister spoke of the panel system that existed before the National Health Service started—about 35 years ago. In those days a doctor got 10s. 6d. capitation fee, but was called upon to treat only the working population, the healthy people—not children or old people. Now he is called on to treat the youngest and oldest—those who demand the most attention—and gets between £1 0s. 6d. and 27s., according to the number of his panel. If we were to translate the former 10s. 6d. into real terms, the doctor should now be getting about 42s. for every patient on his list but, at the most, he gets 27s. We must look at the doctors' pay, although that is not the thing that matters most to them. They have never put money matters

first—had they done so, they would have been at the Minister long ago.
The present position is very serious, and I hope that, to retain people in the Service, the right hon. Gentleman will look at the interest paid on the money set aside by the Government when they stopped the buying and selling of practices. A sum of money is paid out to the individual when he retires, or it is paid to his widow, but if the Minister were prepared to pay it out at age 60 we would retain more doctors in the Service, because I am sure that some retire only to get hold of capital that is earning no more than 2¾ per cent. To keep doctors in the Service, the Minister must make this money available earlier, and must see to it that a more realistic rate of interest is paid on it.
The Minister could also help by removing the threat of closing many of our cottage hospitals and what might be called practitioner hospitals. In the great Hospital Plan, many cottage hospitals, where the general practitioner had access to his patients, will fall by the wayside, and that will increase the gap that general practitioners feel exists between themselves and their patients and themselves and the consultants. If they could have access to these small hospitals, they could practise more scientific medicine and go in for more scientific investigation of their patients—

Mr. W. A. Wilkins: Would the hon. and gallant Gentleman mind telling us who proposed the closing down of those small hospitals?

Sir M. Stoddart-Scott: It is in the great Hospital Plan, which comes up for review—or did, before this Government came into office—once a year. There is some doubt now whether it will come up annually for review—

Mr. K. Robinson: It is under review now.

Sir M. Stoddart-Scott: I am glad to hear that, because some of us feared that the plan was being changed and cut, just as the number of universities to be built is being reduced from four to one.
This crisis has been blowing up for many years, and I believe that what has


brought it to a head is—[HON. MEMBERS: "A Labour Government."] I do not think that it is the election of a Labour Government. I thought it rather mean, untrue and petty for the Minister to say that some consultants have complained about the hospitals simply because a Labour Government had been elected. I do not think for one moment that that is true.
What I think is true is that the doctors saw that £26 million was going to remove prescription charges while they themselves were getting only £1½ million, out of the last recommendations£[HON. MEMBERS: "£5½ million."] Yes, £5½ million now, but it was £1½ million when the doctors rebelled. I think that the consultants also feel that when £40 million—not £26 million, but £40 million—is likely to go in free prescriptions a little more should be spent on the hospitals. I think that they were very suspicious when they heard that the Hospital Plan might not be reviewed every single year.
We must realise that a free and comprehensive hospital service is very costly. We have had it rather on the cheap in the past. If we want a free comprehensive hospital and health service we will have to pay more for it. It may be too costly for any country to bear. No country except Britain has yet attempted a free comprehensive hospital and health service. Some of us remember how, during the 1945–50 Parliament, Sir Stafford Cripps froze the cost of the Health Service at £400 million a year, saying that the country could not afford more. There was a time in the 1950–51 Parliament when the then Chancellor of the Exchequer, the late Mr. Gaitskell, introduced a Bill to put a charge on prescriptions simply because the cost of the Health Service was mounting.
The Government must make a decision. They must pay the practitioners adequately, but, at the same time, they must decide whether a free, modern, comprehensive Health Service—growing more expensive every year with the advances of medical science, the invention of new drugs and the use of new methods of investigation and treatment—is not too much for any country to support unless prepared to pay a large health tax or make some charges.
I am not against charges, because I think it excellent to have such a great service available. Whether or not there should be a charge on prescriptions I would not like to say—or whether there should be a hospital charge, or a hotel charge in hospitals, or a general practitioner charge. It is something that must be thought about, because in the coming years the cost will be so great that we shall have to make a decision.
I do not think that the salary basis of the general practitioners is the only thing in this crisis and I am glad that the Minister does not take that view either. We must find means whereby general practitioners can have more leisure and their amount of work lessened. We must see how we can improve their professional standing, and give them greater and better access to their patients in hospital. We must also give very earnest consideration to the question of how to increase medical manpower or retain for a longer period the manpower we have in the hospital and health service. These are absolute essentials—

Mr. Woodburn: Perhaps the hon. and gallant Member will clear up one point. He said that the nation could not possibly afford such a Service—that it might become too expensive—but I gather that all he suggested was a different way of paying for it, not reducing the Service; that instead of our all subscribing through the Government, we should pay through all sorts of odds and ends of ways. But would that make the Service any less costly?

Sir M. Stoddart-Scott: Not at all—and the right hon. Gentleman knows that it would not make it any more costly. The Service might become so costly, however, that we had to adopt the methods of other countries of having certain charges in a health service available to everyone.
It is essential that the Government should meet the number of demands that doctors have made if we are to maintain both the general practitioners service and a medical service in our hospitals.

6.20 p.m.

Mr. Kenneth Lomas: I will follow the hon. and gallant Member for Ripon (Sir M. Stodart-Scott) into a number of the rather queer excursions he made into the subject of


doctors' pay and the Health Service. The figures he quoted for the increase in the number of prescriptions being issued by doctors were obviously such that he could not substantiate them, at least not to this Committee. Unless the hon. and gallant Gentleman is prepared to stand up now—I will willingly give way—and tell the Committee the source of his information, he should withdraw those remarks. Obviously, he is not prepared to do that.
The hon. and gallant Gentleman said that doctors' salaries had risen by only about 40 per cent. in the last 13 years. He was in the Chamber when my right hon. Friend the Minister said this on 17th February:
… I must put it on record that if this award is included their increases since the Royal Commission was appointed eight years ago have aggregated to around 50 per cent."—[OFFICIAL REPORT, 17th February, 1965; Vol. 706, c. 1214.]
The hon. and gallant Gentleman is again at variance with the facts.
The hon. and gallant Gentleman said that Britain is the only country in the world with something approaching a comprehensive free Health Service. I am very proud that this is so, especially as it was begun by the Labour Government between 1945 and 1950. As my hon. Friend the Member for Halifax (Dr. Summerskill) said on 17th February, hon. Members opposite voted against the Health Service on the Second and Third Reading of the Bill which set it up.
I believe that a tremendous number of tears are being shed on behalf of the G. P. s. We are conscious that there are many hard-working G. P. s who have a very difficult job to do. However, if they persist in their declaration of intent to withdraw their services from the National Health Service, they are in very grave danger of losing the sympathy which exists for them throughout the whole country. A few—more than a few; probably a fair band—of general practitioners are today jumping on the political bandwagon purely because there is a Labour Government in power.
It is important that certain historical facts are borne in mind. Only two years ago the doctors were awarded a 14 per cent. increase which was due to last for three years. The Economist, on 30th March, 1963, speaking of that increase, said this:

What is important, however, is the effect of this 14 per cent. increase on other salary claims. Doctors may now have caught up and overtaken their professional counterparts, but this in itself will give a stimulus to other professions to put in a matching claim. The Higher Civil Service review body will be bound to take the 14 per cent. into account in its current consideration of salaries—so will those sorting out university salaries, especially as Health Service salaries directly influence the salaries of clinical and pre-clinical teachers in universities with medical schools. The three year stability in doctors' pay will certainly not produce stability elsewhere.
It did not even produce stability in doctors' pay, because within a very short time the doctors were asking for, and, indeed, were granted, an independent Review Body to consider their pay and conditions. When that award was made, my right hon. Friend the Minister said in the House of Commons on 17th February that, because this was the nearest thing to an independent arbitration body and tribunal which the profession had had, he was compelled more or less to accept or to reject the Review Body's findings. It was completely to my right hon. Friend's credit that he decided to accept in full the Review Body's recommendations. The recommendations were such as to ensure that those who needed help most to improve facilities and give their patients better service would receive a higher amount. Since then I think that the Minister has perhaps gone a shade too far. He has made considerable concessions.
It should be borne in mind that, including the £5½ million award, the average net salary of a G.P. is in the region of £3,000 a year, with an average gross salary of £4,500. Now, at least part of the profession cries for more. They have become the Oliver Twists of the National Health Service. They cannot make up their minds what they want to do. One minute they wanted to negotiate with the Minister. Then they decided that they did not want to negotiate. Now they have decided that they do. In the charter which they published they want the best of both worlds: they want to negotiate with the Minister and then have a Review Body which will adjust those findings from time to time.

Mr. Frederic Harris: I am prepared to take the hon. Gentleman to my own town of Croydon and show him doctors handling 2,300 patients and earning only


£1,800 after expenses, so the figures he quotes are inaccurate.

Mr. Lomas: If that is so, there must be a considerable number of doctors earning far in excess of £4,500. The idea of the Review Body was to ensure that doctors in need of help would receive it. The way the medical profession has been behaving in the last few months has been such that, if they were trade unionists on the shop floor or elsewhere, they would have been denounced as irresponsible. Indeed, trade unionists would not dream of behaving in this manner.

Mr. Godfrey Lagden: Would not the hon. Gentleman concede that, if the doctors had been trade unionists, this trouble would have occurred a very long time ago and this patience would not have been shown?

Mr. Lomas: If the members of any trade union had received a 14 per cent. increase in pay during the last three years and had violated the agreement within that period, there would have been a tremendous outcry by hon. Members opposite.
Not only are these doctors to whom I have referred the Oliver Twists of the Service. They are almost the Dick Turpins. They are pointing a gun at the Minister's head. They are asking him to stand and deliver some more money. The Minister should not at this moment give way. He should stand fast, because the doctors seem to want their cake and halfpenny at the same time. They are demanding another £40 million. We should ask the profession how much they add to the work that they do and to the salaries that they obtain by taking on the number of private patients that they do. What effect has this on their salaries and, indeed, upon the conditions in which they work?
Having been granted the award of £5½ million, they should immediately remove the threat to withdraw their services from the Service. I implore the Minister to tell them that he is not prepared to negotiate until that threat is removed.
Referring again to the article in the Economist, which spoke of the effect the 14 per cent. increase two years ago would have on other claims, before I came to

the House of Commons I was employed in the Service for nine years. I assure hon. Members on both sides that amongst the ancillary workers, clerical and administrative staffs, and others in hospitals and elsewhere, there is a seething cauldron of discontent about the pay and conditions they have to endure. How can we expect them to endure those conditions when the doctors are demanding this £40 million?
The facts—and the House should know them—are to be found in the booklet issued by the Whitley Council which sets out rates of pay in the National Health Service. They are as follows: Group 1, general porter, gross pay £10 5s. 8d. Group 3, ambulance attendant, £10 13s. 8d. Group 8, attendant on aged and infirm, £11 13s. 8d. On that gross pay they are expected to keep a wife and family. The net pay is considerably less. How can we expect these people to accept this kind of wage in the light of the extravagant demands which are being made by members of the medical profession? 
If I may now refer to the charter, I agree that the objects of the charter are, in the main, excellent. It is, indeed, the eventual goal towards which we should move in many respects.

Mr. Eric S. Heffer: Would my hon. Friend not agree that the doctors were threatening to withdraw their labour before they knew the terms of the charter?

Mr. Lomas: That is true. We know that it was concocted in a short space of time in a country retreat or elsewhere.

Dr. Wyndham Davies: rose—

The Deputy-Chairman (Sir Samuel Storey): I would point out that the time for this debate has already been severely restricted. I hope that hon. Members will not take up too much time with unnecessary interventions.

Mr. Lomas: I accept the charter as it stands as being the eventual goal towards which we should move. Certainly, the abolition of certification is an extremely good thing. The doctors recommend the setting up of an independent corporation to be financed from public sources. They say that we should lend public money for improvements, to acquire surgery


premises, to build and lease purpose-built premises and provide medical and practice equipment. All those are wonderful arguments for the real answer to the problem, which is a full-time salaried service by the doctors.
This would not destroy the relationship between doctor and patient. It would mean that with the help of central Government and local authority money, doctors' pay and conditions could be improved, that the Health Service could be built up, surgeries could be made more effective and the clinics that they require could be provided.

Dr. David Kerr: And the doctors could form a stronger trade union.

Mr. Lomas: And the doctors would be made into a stronger trade union.
The doctors provide a useful and valuable service, and we should try to extend the system of group practices and the rota system. We must ensure that the service they offer is high, and that they have the right facilities with good pay and conditions. But this can only be done on the basis of a salaried service, and I ask the Minister, when he speaks of injecting these new ideas into the negotiating structure, to think in terms of putting forward some ideas which will lead to the creation of a full-time salaried service which will benefit the medical profession, the patients and the National Health Service as a whole.

6.33 p.m.

Dame Edith Pitt: I thought that the Minister was very conciliatory, and I was Fateful to him for taking the Committee into his confidence and telling us of the developments which have taken place since this matter was last debated. I feel that the Minister will probably say, "Heaven protect me from my friends" after the last speech, for the hon. Member for Huddersfield, West (Mr. Lomas), unfortunately, introduced into the debate a note of heat which has so far been absent.
I should like to go back to a comment which the Minister made in his closing speech in the debate on 17th February. He referred to the fact that one ex-Minister and three ex-Parliamentary Secretaries had contributed to

the debate, and that one other ex-Minister and one ex-Parliamentary Secretary had sat through the debate. As the No. 2 silent one on that occasion I should like to make a contribution today. I think that this links with the Minister's comment which I have just mentioned.
If so many of us who have had the honour of serving in the Ministry of Health sit through a debate, whether we take part in it or just listen, it shows our concern for the Service and our desire to ensure that it shall be a good Service. It is a good Service. In all the countries that I have visited I have seen nothing better, and in most cases not as good as we possess in this country. It is also valued by the general public.
Obviously, the National Health Service cannot remain static. Already, comments have been made in the debate on the changes in the pattern of medicine. the demands on the Service, and the new techniques which have been introduced. Therefore, we must expect changes, and I think we face the possibility of a considerable change in the National Health Service from what it was when it began 17 years ago. This is because there are stresses and difficulties. The difficulty which concerns us today is the frustration felt by the family doctor. It is very real and serious, and I was very glad that the Minister said that he was prepared to negotiate. I hope that the profession will be equally co-operative, though I do not want to underestimate the strength of feeling in the profession. This frustration is not new.
I am sorry that the Minister, in chiding some of the consultants, let himself in for the general condemnation that he was suggesting the doctors were taking action because there had been a change in the political complexion of the Government. This is not true, and anyone who refers back to the debate we had in July last year will find that the present Minister, the then Opposition leader in health matters, said that general practice was facing a critical situation, and so did many others of us in that debate. I do not think the Minister is helped by his right hon. Friend the Minister of Technology who, of all people, is the last one who should chide an organised professional body when it attempts to improve the pay and conditions of its members. This difficulty and frustration in


the medical profession, and particularly among family doctors, is a compound of several things. Pay certainly plays a large part. So, I think, does status, and, though this is a minority point and has not yet been voiced, some of the family doctors are quite concerned about the claims made on them by a minority of their patients, the less thoughtful patients, who make unreasonable demands.
Some of the doctors in Birmingham complain to me that it is the doctor who has to control the demand and that in that respect it is the doctors who are doing the work of the Government. I would say, as I have said to them, that there is another side to that matter. It has always seemed to me that doctors receive a privilege in that nominally they are employed by a Government Department, but are free to practise their profession entirely on their own account. I make this point only briefly and without any wish to give it any major importance; nevertheless, it is one which I hope the Minister has in mind. A number of patients do make excessive demands on the doctors, and that does not help. As one old doctor friend of mine, now dead, used to say "You cannot put your indignation on the bill."
This trouble, with the sense of frustration and criticism, has been brewing for some time. One of the difficulties has been that the profession has not spoken with one voice, despite belonging for the most part to the most tough and hard-bargaining trade union that I have ever had dealings with. The B.M.A. is a very powerful body, but up to now the doctors have not spoken as one profession.
To turn to the charter, one could agree, as the hon. Member for Huddersfield, West said, with most of the points in it, and certainly those in the left-hand column of the first page, which gives the ideal set-up for family doctoring. One of the things which I hope might develop from the negotiations is that the doctor might have more time for his patients. From inquiry in the areas in Birmingham which I know best, I find that the doctors are able to give only five minutes to six minutes, on average, to each patient. Very often that is quite enough. One does not need five minutes to give a certi-

ficate but some patients, and especially the elderly, need a longer period of time. I hope that, arising out of any changes made, it will be possible for doctors to give more time to individual patients, because there is another side to the penny. Some of the complaints which one receives from members of the public is that the doctor does not seem to have enough time to deal with their problems.
The doctors' suggestion that they need six weeks' holiday is not unreasonable provided that they take advantage of that longer period to undergo some postgraduate training. Anything that we can do to encourage doctors to keep up-to-date and to undertake refresher courses and post-graduate work is certainly worth while, not only for the doctors themselves and for the National Health Service, but most of all for the patients. Therefore, if six weeks' holiday were practicable and most doctors accepted, as I think most of them do, that part of it should be devoted to refresher and post-graduate work it would be right to concede it.
I appreciate the point they make about diagnostic aids. This has been recognised for some time. In some cases they have been provided, but the provision is patchy and should be widened. Two of my doctor friends in Birmingham say that what they would most like to have for the treatment of patients is an E.C.G. machine. I believe that it costs about £250, and I realise from even my lay knowledge that it would be most valuable to patients.
I understand that the doctors wish to be paid by methods most acceptable to them. The majority want capitation fees, including an items-of-service basis and others want a salaried basis. I differ from my right hon. Friend the Member for Bridlington (Mr. Wood) in that I do not agree with a salaried basis. I do not think that it is to the best interest of either doctors or patients. I believe that it would be going back to something which the doctors themselves opposed vigorously when the Health Service was introduced.

Mr. Wood: I would remind my hon. Friend that I pointed out that this proposal raised one of the most profound problems of all, that is, how the personal service could be maintained. I hope that there is no disagreement between us on that.

Dame Edith Pitt: There is no disagreement in that respect with my right hon. Friend. I only make the point that in the negotiations the infinite variety of views are better considered, and I was going to say that there has been a change over the years. I know now that a number of doctors, particularly the younger ones, would favour a salaried service. Therefore, however awkward it may be on the face of it, it seems, to have a triangular system, the Minister ought to consider this.
A matter which is not in the charter, but on which the Minister said that he was prepared to put forward his own view, is the need to consider a seniority award for the older doctors. I regret that a merit award was not found practicable. There is a case for a seniority award, especially when one remembers that, contrary to the position in most professions, the older the doctor gets the less likely he is to be in the top earning bracket.
Practice expenses would mean the end of the pool, and this surprises me because it was something which the doctors were so insistent on in their proposals at the beginning of the Health Service. But the Minister has said that he intends to carry out the promise made in July last year seriously to consider a method of reimbursing practice expenses and also, I gather, his promise on surgery premises.
A point not raised in the charter which might be considered once more is the development of health centres. I have not been very keen on the health centres because I think that they drive the doctors more and more towards a State service. This was the doctors' view at the beginning of the service, and when some local authorities tried to provide health centres we found the utmost reluctance on the part of the doctors. Again, this is one of the changes which have come about in 17 years and ought to be looked at again.
The charter said that the profession sees no need for late evening surgeries. I disagree. I think that there is, and probably will always be, a need for some evening surgeries. I would go as far as to say that I do not think that that need apply to a particular doctor on every night of the week. Some

arrangement could be made whereby some doctor would have his surgery open late one night a week. This would be better for the doctors themselves because some prefer to have the little leisure-time they get in the afternoons. What is needed is more flexibility than there is in the present arrangements.
Another point made in the charter was the doctors' feeling of frustration about the disciplinary machinery now in operation. This, also, is a real point. I hope that the Minister is prepared to consider whether anything can be done to apply the disciplinary machinery in a different way. No one suggests that it should be removed, but doctors find it irksome that a number of the smaller complaints are made and they have no redress.
The doctors suggest that the practice of issuing certificates should be altered, but they are quite open about it in saying that they have no method to suggest to the Minister. I have one which the right hon. Gentleman might consider. I have always known that the need to give certificates is irritating to doctors and I said so in our debate in July last year. I wonder whether they would like to be relieved of that need, because, apart from the National Insurance certificate, this is an extra for which they are paid, but I am told firmly by my doctor friends that they would like to be rid as far as possible of the need to give certificates.
Patients need a certificate for National Insurance purposes and the doctor is required to give one every week for the first four weeks, but surely there must be cases, for instance, when a man breaks a leg, or he has a serious heart attack, where it is obvious that he will be away for a month or even longer. If he is in hospital the authorities accept a monthly certificate. Is it not possible for the Minister to discuss with his right hon. Friend the Minister of Pensions and National Insurance some alteration which would require doctors to give weekly certificates only in cases of short-term illness?
If he could discuss with his right hon. Friend the Minister of Labour the other question of the need always to present a certificate to one's employer, this, too, could lead to helpful change. Some industrial companies require from all employees a separate sickness certificate.


Not all companies do. Some are sensible enough to have a sight of the National Insurance certificate which is at present required by law; this National Insurance certificate is then sent on so that the employee may claim sickness benefit, and the company has seen all it wants. This arrangement ought to be more widely adopted.
I am not quite sure how one can deal with the certificates required for school purposes, and under the rules of benevolent associations like the Oddfellows, Foresters, and so on. All these certificates the doctor is required to sign. I have asked my doctor friends how much of their time is devoted to the signing of certificates, and I can tell the Minister that their estimates vary between 10 per cent. and 40 per cent. If we could cut out the 10 per cent., how much more valuably that time could be devoted to attention to the sick, and what a relief it would be for the doctors, too.
I should like to go on, but this is a short debate and I realise that there are still several hon. Members who wish to take part. I wished to intervene because of my concern about the present situation in family doctoring. I am sure that the majority of doctors are not prepared to carry on under the present contract. The Minister has a remarkable opportunity in the negotiations now going on to try to deal with the frustration which exists, to try to re-establish good relations with the general practitioner, and to fulfil something which he himself said on 27th July last year, when he ended his speech with these words:
The G. P. s are demanding, above all, the tools with which to do a better job for the patient and for the nation, and by now they know that only a Labour Government are likely to provide them."—[OFFICIAL REPORT, 27th July, 1964; Vol. 699, c. 1023.]
This is a chance for a Labour Government to do something. I beg the Minister to take it very seriously. His opportunity is not only to carry out his own promise, but to restore family doctoring to what it should be and make it possible for the profession to contribute as it can to our national life.

6.53 p.m.

Dr. David Kerr: I think that everyone is probably as tired and irritated as I am by the constant repetition of the phrase "the doctor's

dilemma". It would not hurt if we thought for a moment of what Shaw's doctor's dilemma originally was. He had a treatment which he could make available either to the husband of a woman he coveted or to a poor doctor. If there were any parallel with that situation today, no one, I hope, would expect me to pursue it in the House.
The very charming and seductive hon. Lady the Member for Birmingham, Edgbaston (Dame Edith Pitt) was clearly the voice of the siren. She will forgive me if I take issue with her at once, and I preface what I have to say with this. There can be no doubt about the compelling nature of the doctors' case. There can be no doubt about their frustration and irritation. What there can be doubt about is the way that irritation and their years of deprivation are being misused.
The hon. Lady saw fit to take issue on with my hon. Friend the Member for Huddersfield West (Mr. Lomas) on the small amount of heat which he engendered. I go a long way with my hon. Friend but he makes one mistake which many of us continually make. He confuses the doctors with the doctors' leaders. This is the mistake which the doctors themselves make and it is a cause of much of the trouble.
My hon. Friend the Member for Huddersfield, West made a number of points, but I wish, first, to comment on some of the observations and suggestions made by the hon. Lady the Member for Edgbaston. Towards the end of her speech, she raised the vexed question of certification. I am sure that she is aware that the subject of long-case certification has been discussed over and over again by the National Insurance Advisory Committee and by the medical profession. In fact, the majority of certification work undertaken by the general practitioner is not for the long cases, the broken leg, the heart attack, pneumonia, perhaps, or tuberculosis. The great bulk of such work arises from the need to have a few days off.
These short periods off work are quite well merited and I am not suggesting that people misuse the certificate system, but it does represent the great bulk of the work involved. Someone comes in on the Monday, he wants a few days off, he goes back the following Monday, and he has to have two or more certificates


in one week. I do not think that the hon. Lady ought to speak about reducing the burden or private certification. For many general practitioners it is a valuable source of income, and a source of income which the Income Tax inspector has the greatest difficulty in assessing.
The hon. Lady said that the medical profession was not talking with one voice. Of course we are not talking with one voice, and this is the nub of the problem in the present situation. On this side of the House there are several doctors, and a word with any one of us would show that each speaks with a different voice about it. The reason is that every doctor has his own problems. In my practice, we have our problems, the man down the road has his, the man out in the countryside has very different problems, and in the Black country, the Welsh mining valleys, and the northern industrial districts, places for which we on this side claim to have a special concern, the problems are probably at their most acute. It is in these latter places that doctors find the work-load heaviest, the illness-load the highest, the demand the greatest, and the hope of relief the least.
Our problems differ greatly, and this fact exposes the failure of the British Medical Association when it repudiated that first faltering step recommended by the Review Body which would have differentiated a tiny bit between different practice problems by providing a solution which was not applicable as a national blanket solution. But the B.M.A. has chosen to draw the blanket up tightly round its chin, and we are left now exactly where we were before, with a frustrated profession and little immediate prospect, until the charter has been negotiated, of an improvement in the services offered to the patient.
The National Health Service was created for the patient. It was not created for doctors. Those of us who serve in the Health Service and are proud to do so enjoy widely differing rewards for the services we give. My hon. Friend the Member for Huddersfield, West reminded us that there are ancillary people in the Health Service who were also affected by pay claims. This was brought home to me very forcibly the other day when I met a young sister from the ward of a local hospital. She

looked me very straight in the eye and said, "I understand that the doctors are hungry today". I acknowledged that they were, and she said very pointedly, "We are hungry, too".
It is impossible to invite a Government to accept the representations made by one section of one profession in a large concern like the National Health Service and, at the same time, invite them to ignore the position of all the other people working similarly in the Service.
Apropos diagnostic aids—I am sorry to deal with these things in grasshopper fashion, but this is how the points came out—the hon. Lady referred to the provision of the E.C.G. machines, and I heard the whispered comment from one of my hon. Friends, "Heaven forbid". There is a great deal in both points of view. I confess that, if anyone presented me with a E.C.G. machine, I could use it only as decoration on my grand piano, if I had a grand piano. In fact, the expertise involved in taking, recording and reading electrocardiograms would require of the overworked doctor a degree of skill and time consumption which would make his whole case, that he is overworked, fall to the ground.
There is a small medical journal that is, perhaps, not seen by many hon. Members. It is the journal of the College of General Practitioners. Most opportunely—perhaps there has been a little co-ordination—someone this month has written an article on the use of these machines in general practice. One of the points made is precisely the difficulty of the non-specialist reading electrocardiograms in dealing with this sort of service in the normal course of general practice.
The vexed question is: what precisely is general practice and what are we to do to help it develop? Of course, there are many different points of view, and I am expressing my own. It seems to me that general practice is developing as a form of practical social medicine, that it is being forced away from the rather conventional clinical type of medicine which involves hospital beds and facilities. Of course, these things are essential but the emphasis is changing.
When we talk of the development of general practice, dare we talk about it


as though it were in a vacuum? How can we begin to talk about changes as though they concern only general practitioners? Changes are occurring in the behaviour of the users of the Health Service and in the other professions and other methods of practice in it. The whole problem lies in the fact that nowhere, in any British university or technical centre or Government Department, is there a professor charged with the study of the organisation of medical care.
I contrast this with the situation, for example, in the Soviet Union, or in Australia. A year or two ago, we lost one of our best men, who took up a professorship of the organisation of health care in Australia. In the Soviet Union, there are large institutes in every State studying how to bring the best and most effective medicine to bear on the point of contact with the patient so that he can have the maximum benefit from the advances which are changing the face of medicine.
In this country, we have taken—rightly, I hope—the view that the most important point of contact is through the general practitioner. But can anyone believe that a compelling and sensible answer can be contrived in 48 hours to the years of shilly-shallying in which we have never begun to discuss the problem in depth, profundity and with knowledge of the facts? Is this the sort of catchpenny idea about which we can talk?
Let us look at the charter. Of course, the hon. Member for Birmingham, Perry Barr (Dr. Wyndham Davies) was right in saying that much of the charter turns upon the campaign conducted so vigorously by one of the smallest of the doctors' organisations—the Medical Practitioners' Union. Indeed, when a few of us met representatives of the union here a few days ago, they were somewhat hot under the collar at seeing their clothes stolen while they bathed. However, perhaps it does not matter as long as the answer is right. Some of the framework that the charter provides for the Minister to enter negotiations hopefully is acceptable to many of us. But it seems to me that to tie it so closely to the question of the quantum of remuneration is cutting the throat of the hope that might be held out for proper negotiations.
Let us look at one or two points. First, there is the proposal for a five and a half day week. Where does that fit in with the much vaunted idea that we have to have continual personal service? The two are paradoxical and opposed.
The idea of personal service was thought very much of by the hon. and gallant Member for Ripon (Sir M. Stoddart-Scott). Incidentally, in parenthesis, I think that if we are to have equality of status for doctors there should be some way in the House of Commons of calling a doctor M.P. something like "honourable and qualified Member". However that may be for the moment, the hon. and gallant Gentleman was very "hot under the collar" about the question of personal service. If the charter is acceptable as the framework, with a five and a half day week, and if the hon. Lady the Member for Edgbaston is right about her ideas of one or two evening surgeries with patients rotating between doctors, where is the idea of personal service?
In fact, of course, we and the consumers in the National Health Service have long since abandoned the idea of personal service when it applies to the emergency in medicine. The consumers retain it, and quite rightly, when their contact with the doctor involves the exploration in depth of their particular problems. But the person who suffers a heart attack or falls under a bus does not have a personal problem immediately. He has an emergency problem and it does not matter to him whether it is Dr. Jones or Dr. Smith who comes to his aid as long as the doctor is a skilled and qualified man.
The conflict in general practice today is between providing continual emergency service and providing exploration in depth—the time consuming, psychosomatic type of consultation. Today, that sort of general practice is no longer the Victorian medicine of our forefathers. It is more than merely family medicine. It is environmental social medicine, a question not only of knowing the individual and his job but of knowing also his family and its fate, his background and anxieties, his housing situation. Above all, it is knowing the full range and panoply of social service that the general practitioner can call on to meet the needs of his individual patient.
We are not dealing with one problem, topographical, demographical or medicinal, but with an absorbing, colourful variety of problems and to suggest, as the doctors' leaders are trying to suggest, that we can provide one solution in a four-page leaflet thought up in a country house over the weekend is the opposite of intelligent negotiation and good planning.
This is our grumble about the way in which the medical profession is being led at the moment. But let no one confuse our attack on the leadership with any lack of sympathy for the lot of those doctors who are genuinely working a long week, have little relief and inadequate reward. Our hope and faith are with them, just as they have always been with them.
I now turn to the sort of ideas that we should be looking at. Of course, the spread, the availability, of doctors is cardinal. We cannot accept the urgings of a leadership which overlooks the position in which the country and the profession is placed by the lack of medical manpower. What is the use of urging upon us a charter which, if it were to be satisfied, would demand more medical manpower than we have or can hope to have for the next five years? It is true that we must do something to stop the loss. We should be doing the same as my right hon. Friend the Secretary of State for Education and Science is doing in re-recruiting married women teachers. We should be re-recruiting married women doctors.
The Medical Women's Federation has made great play with the lack of opportunity available to married women doctors. In my own practice we have made it a cardinal point to employ at least one woman for the last six or seven years. Our difficulty has always been to make contact with those available to do this sort of work. Is there not some means by which we can explore their availability and assist them to come back not merely to general practice, but into part-time hospital practice?
I take the point made by the hon. and gallant Member for Ripon—that the crisis of manpower will be in general practice tomorrow but that it is in the hospital service today. One of the distressing smaller aspects of the present crisis is

that it is distracting our attention from the less dramatic, but far more immediate crisis in hospital manpower. In talking of the hospital service I must beg, very tactfully, to differ a little from my right hon. Friend the Minister of Health.
I welcome the explosion among hospital surgeons. I do not think that even the most ardent member of the Fellowship for Freedom in Medicine could really expect anybody to believe that the ceilings fall down in our university college hospitals because of the vile machinations and neglect of my right hon. Friend. I do not think that this was the point the surgeons were making. I think that they were trying to hide the point of what they were saying, but they did not manage to hide it from me or from any other people.
It is that the hospital service and the operating theatres are in a mucky state. Of course, it is right and proper that they should express the hope that a Labour Government will do something about it, because this is precisely what will happen. They may have erred a little on the side of dramatic expression, but we are glad to have them on our side. They have been on the other side too long. Perhaps this has something to do with the more pressing attitudes which are now being expressed.
The hon. and gallant Member for Ripon made great play with the question of prescriptions and prescription charges. We remain quite uncompromised in this embarrassment. The numbers of prescriptions which appear in chemists' shops are a manifestation of many more social factors than how much they are charged to the patient. They are a manifestation, as I suggested to the hon. and gallant Gentleman, of the normal rise in illness rates.
They are also a manifestation of the prescribing habits of doctors and it is not unknown—and I make this as no charge of malignancy—that if one happens to be feeling a certain resentment towards a certain institution, one may not be too inhibited about doing something to bring that institution into a little disrepute and to express one's resentment in that way. I do not mind confessing, even in so august an institution as the House of Commons, that I myself have sometimes been guilty of that sort of frustration


when I have been pressed and when patients have been harrowing. These things are done not because the patients do not have a right to their prescriptions and not to damage the Health Service, but so that we can get on with more work.
But the most important manifestation is that which we do not hear mentioned by hon. Members opposite. Is it not at least a possibility—and I put it no higher—that if there is an upsurge in the demand for prescriptions, it is because there are many people who have not been able to afford them over the last few years and who are coming at last? Just as the demand in 1948 led to a great upsurge, so there is now a demand at a particular time precisely because people have been denied prescriptions which they have required.
Would it not be far better, if only doctors were provided with the necessary facilities, for everybody to feel free to go to his doctor even with a cold in the nose? Let me be technical for a moment and remind hon. Members that to many people a cold in the nose seems a much more serious illness than it is generally thought to be and is best treated early rather than neglected. I am not one of those who believe that everybody with a cold should be sent home to bed with a glass of whisky—unless it is available on the Health Service. It would be a far better scheme for anybody with a minor ailment of that sort to be able to receive proper medical advice and treatment.
We have said time and again that what we aim at, not for tomorrow or for next year, but in the course of time, is a health scheme so that people can go to the doctor to make sure that they are staying well and not to find out why they are ill. That is what we are aiming for in the Health Service and that was what was intended to be its structure when it first came into being. That is what we want to return to—not merely more time for the doctors, not merely the more facilities which they need and which many of them have acquired out of their own pockets. What we also need are incentives to doctors to serve in areas where the problems of morbidity, illness and mortality are greatest and most challenging.
We also need—and this is beginning to occur, thanks to the statesmanlike attitude of my right hon. Friend the Minister—medicine to be a discipline and a justification for a man's life and a fulfilment for him. I am sorry to be a little poetic and vague, but somehow I cannot phrase this correctly. If we are to ask doctors to work in the Rhondda and in the Potteries and in Middlesbrough, we have to give them something more than money. We have to give them a justification for devoting their lives and asking their families to devote their lives to areas which are often very unattractive and where the work is often hard and unrewarding.
This is the sort of background and climate which we have to provide. We cannot provide it when we are bogged down on vexatious items of remuneration. I hope that this charter, wherever it springs from and whatever its defects, will provide the new gateway for us to go through with the medical profession.

7.15 p.m.

Dr. Wyndham Davies: I am most grateful to the hon. Member for Wandsworth, Central (Dr. David Kerr) for allowing me to rise as an hon. and qualified Member. I am not so grateful for some of his suggestions, such as that these things are done so much better in the Soviet Union. His remarks, which were addressed to the leaders of the British Medical Association, showed that his long contact with the Socialist Medical Association has taken him completely out of touch with his colleagues, who have felt so deeply about this issue that they have forced the leadership of the British Medical Association to produce this charter and to negotiate it on their behalf.
This is an example of the rank and file forcing their leaders into doing something effective. The leaders of the British Medical Association are highly responsible individuals and, for years, have negotiated with Governments. It is most unfortunate that time after time we should have had these attacks on that leadership from Ministers and hon. Members opposite.
We have had some interesting suggestions this afternoon. My hon. Friend the Member for Birmingham, Edgbaston (Dame Edith Pitt) made many valuable


suggestions, and I hope that the Minister of Health will take them into account. I disagree with the acceptance of the Minister's statement by my hon. and gallant Friend the Member for Ripon (Sir M. Stoddart-Scott), because I believe that the statement will be received with great dismay throughout the medical profession. The right hon. Gentleman has suggested merely a delaying operation, and that is not what the profession wants at this stage. It wants him to state his principles clearly so that by the end of the debate it will know what its position is.

Mr. William Shepherd: Can my hon. Friend tell me why these proposals, on which a strike has been threatened, have not been put before Ministers before? Why has the profession waited all these years and then said that if these proposals are not implemented doctors will withdraw their services?

Dr. Davies: I am afraid that I cannot answer on behalf of the profession. During the course of my argument I will try to show why this situation has arisen.
The right hon. Gentleman said that the charter did not deal very much with method and organisation, and he, like others, has constantly stressed the question of remuneration. There are eight items in the charter and some hon. Members may not have had the chance to look through them. It is the seventh which deals with money, and it may be worth mentioning the others.
They are: first, the doctors want adequate time for each patient; secondly, they want to be able to keep up to date; thirdly, they want to have complete clinical freedom; fourthly, they want to have adequate, well-equipped premises; fifthly, they want to have at their disposal all the diagnostic aids, the social services and ancillary help which they need; sixthly, they want to be encouraged to acquire additional skills and experience in special fields; seventhly, they ask to be adequately paid by a method acceptable to them and which encourages them to do the best for their patients; eighthly, they do not ask for a 5½ day week, but they want a working day which leaves them time for some leisure. These are perfectly reasonable suggestions. All members of the profession particularly

reject the idea that it is pay entirely in which they are interested.
Today we are having a further discussion on the problem of the National Health Service which has been under discussion for 17 years. No one envisaged, least of all Beveridge in his scheme, that it would be necessary to meet more than the need revealed in a wartime survey. At that time, medicine was in turmoil. Doctors came back from the war to reconstruct their practices. They had no idea how many patients they were likely to have. Hospital reconstruction and building had been neglected during the war. A revered Member of the House of strong-minded views upset the general practitioners and skilfully out-manæuvred leaders of the medical profession in 1947 and 1948. I am afraid that later Ministers of Health, and not least the present Minister of Health, have suffered from those early days when the profession was out-manæuvred in its negotiations.
Many people are asking why the dispute today is more serious than ever before. I think that the answer is that 17 years of effort have seen a deterioration in the general practitioners' position. I am afraid that certain hon. Members opposite—my hon. Friend the Member far Edgbaston quoted from the speech of the Minister of Health last year—have been fostering discontent for two years for political ends, and now the chickens have come home to roost.
The Minister has given two long articles to the publication Medical News in the past 12 months. The last, a few weeks ago, was very non-committal, apart from some thoughts on Wilkie Collins. When he was challenged on the abuse of general practice by inconsiderate patients, he said:
People only go to the doctor when they have to. I don't think any good G. P. will want to bring about that situation.
This shows how much the right hon. Gentleman is out of touch with the profession.

Mr. K. Robinson: I should correct the record, since Ministers do not write articles for journals. The piece to which the hon. Gentleman is referring was an interview which I gave to the editor of the Medical News a couple of weeks ago.

Dr. Davies: I thank the Minister for the correction.
I will go on with this interview in which the Minister, discussing the distress caused to older doctors by the loss of the capital value of their practices, said:
Do you really want to go into that? It is a complicated problem.
In his earlier article—

Mr. Robinson: I am sorry to keep interrupting the hon. Gentleman, but he must not traduce this piece in the way that he is doing. This was an interview which was conducted against the clock. This is a complicated matter. The editor had told me that he had a number of questions which he wanted to ask me. The interview was being taped and therefore he reproduced the taped answer which I gave to his question.

Dr. Davies: I thank the Minister for that information. Perhaps I may be allowed to quote from the article which the Minister wrote for the Medical News on 24th January, 1964, when, presumably, he was not working against the clock. He said that he did not want to go into detail about what would happen if the Labour Party came to power and he became Minister of Health, but that there would be a new deal for doctors in the National Health Service in the event of a Labour victory. I know at least one Conservative doctor who voted Labour as a result. Now they want to see the promises fulfilled. This is one reason why the right hon. Gentleman is in trouble today.

The Parliamentary Secretary to the Ministry of Health (Mr. Charles Loughlin): A grown man!

Mr. Cyril Bence: Do not believe it.

The Deputy-Chairman: Order. We will make better progress if there are not so many interruptions.

Dr. Davies: In the General Election in Birmingham, the hon. Member for Birmingham, Small Heath (Mr. Denis Howell), who had been having a clandestine discussion with leaders of the Birmingham Action Group of doctors, when he wished to embarrass a Conservative medical officer of health, made the following statement which appeared in the Birmingham Post:

Mr. Denis Howell, Labour candidate for Small Heath and a member of the Labour Party's Parliamentary Health Committee, said: 'The G.P. has to utilise the services of his wife in the practice for secretarial help, for which he receives no remuneration, and he has to provide a stand-in when he is away on holiday'.

Dr. David Kerr: On a point of order. I thought that I heard the hon. Gentleman refer to a Conservative medical officer of health. I suggest that that is a most improper appellation.

The Deputy-Chairman: That is not a point of order.

Dr. Davies: I should like to continue with the quotation:
Mr. Howell added that while the Labour Party had 'sympathy' with the point of view of the doctors and the need to extend the health and hospital service and provide proper conditions under which professional men can work, this should not be done at the expense of people who were ill.
This is fine. The only point that I am making is that in previous speeches made by hon. Members opposite it has been suggested that the trouble has arisen only since the Labour Party came to power, but that the discussion had been going on in the past.
Some of the trouble has arisen because, although the Minister of Health has claimed that, since he is a doctor's son, he is very sympathetic to the medical profession, the hon. Member for Loughborough (Mr. Cronin), in particular, has indicated—and here I should like to quote from a news item in the Observer of 7th March this year. It said:
Mr. Robinson, the Minister of Health, a doctor's son, was psychologically hostile to the medical profession.

Mr. Bence: The hon. Member for Loughborough (Mr. Cronin) is probably psychologically affected.

Dr. Davies: I am sure that we will be very grateful for that explanation. I hope that not all hon. Members opposite agree with the hon. Gentleman.
Why is trouble still going on? Let us consider the rather peculiar statement of a member of the Cabinet, the Minister of Technology, who in a Press report in The Times criticised the doctors, who, he said,
had accepted arbitration and when the result went against them held a pistol at the head of the Government by threatening to leave the


National Health Service. … The Government were not going to be bludgeoned into making pay awards so that doctors' remuneration was out of relation to other wages and salaries.
We have the background of the present dispute—years of frustration, more recent disappointments and unhelpful speeches by the Minister, some of his Cabinet colleagues and his hon. Friends.
What is the solution? First, I should like to ask what we are discussing. Are we discussing the whole problem of the middle-class squeeze which is going on? Are we discussing the whole problem of professional men in British life? Are we discussing the problem of keeping up with modern medical advances? Are we discussing the deficiencies of a State service, which are well-known to many of those who have to serve in the Services, in the Civil Service or any nationalised industry; or are we discussing the sheer impossibility of financing such a scheme from the public sector?
What many sincere Socialists should bear in mind is that in dealing with a highly trained body of men who have only their personal skill to sell, we are dealing with a skill which has international value, and unless hon. Gentlemen opposite propose to conscript the medical profession in a totalitarian system, the conditions under which doctors work must bear international and national comparison, otherwise they risk destroying a noble concept for the needy.

Dr. David Kerr: We hear a great deal from the hon. Gentleman and his hon. Friend about migration and international attraction. What they overlook is that the international attraction was taking doctors away from this country when there was not a Socialist Administration. What was the hon. Gentleman saying then to attract doctors back to this country? Would he care to give us some indication of that?

Dr. Davies: I do not think that is entirely relevant to what I was saying, because, first, I was not in the House at the time, and, secondly, I made statements which were reported in the Birmingham Press and for which I was continually attacked not only by certain members of the party opposite, but by some of my own party who thought that the National Health Service was a splendid thing.

Dr. Kerr: Do I gather that the hon. Gentleman does not?

Dr. Davies: No. There are criticisms to be made of it, and I should like to make them now.
What are the irrefutable facts about the Health Service? First, we have to bear in mind the whole question of cost. The cost of the Service to the nation this year is about £1,000 million. This compares with an estimate of £268 million for the first year in Beveridge's plan, and an actual expenditure of £373 million. Aneurin Bevan once said:
Little men do silly little sums.
Is this such a little sum? I have been doing a little totting up, and I have worked out the cost of the Health Service since its inception has been about £10,000 million, which is an excess of £8,000 million on the original costing done by Beveridge. [Laughter.] Hon. Gentlemen may laugh, but this is an extremely serious matter.
During the war years a highly responsible inter-Departmental committee worked out a comprehensive scheme for the social services. It was supposed to be costed, but, because it was incorrectly costed, it was costing the nation more and more each year, so much so that, as has been mentioned, Sir Stafford Cripps had to impose a ceiling of £400 million on the National Health Service. This has to be considered responsibly by any Government, whether Labour or Conservative. Some control must be exercised over cost.

Dr. Kerr: These are very interesting figures. Perhaps the hon. Gentleman will want to enlarge and elaborate on them. It would be interesting, from an economist's point of view, if he could say whether his calculations include the influence of the prescription charges, the hospital boarding charges, the change in the value of the stamp, whether there was—

The Deputy-Chairman: Order. We cannot have these long interventions.

Dr. Davies: Obviously, there is not time to develop this theme, but I hope that there will be an opportunity for a full debate on this matter later.
The second problem which faces us today is that of priorities in the Health


Service, and the right hon. Gentleman and his Department know that there is a problem of inter-Health Service priorities.
The third problem facing the Service is that of monopoly. We know what hon. Gentlemen opposite think about monopolies. There is a virtual monopoly of medical care in this country and there is an absence of substitutes for the patient and for the employment of dissenting workers, which means that if a doctor does not like the Health Service he has but a tiny chance of gaining a private practice here. Private practice accounts for only about 3 per cent. of the total medical care provided in this country. This was never intended in Beveridge's scheme, and this has led to a State monopoly.
Fourthly, there is a shortage of personnel—of doctors, nurses, and many other medical workers. I think that we must go back to the Willink Committee. This was an example of a group of experts being brought together by a Government Department to make a report to a Minister, and then to plan ahead for the future. Having laid their splendid plans, they considered the whole question of the future supply of doctors during the period 1961 to 1971. That is the period which we are considering. They reckoned that by 1961 the supply of doctors would be sufficient to enable the intake of medical students to be cut by 10 per cent.
We can argue whether it was right for the Minister of Health to accept the Willink Committee Report, but we are going to base many of our plans for the future on this type of Committee and its Report. In fact, I have no doubt that the Minister of Health will set up a Working Party to advise him on the Health Service, and I must remind him, therefore, that the Willink Committee made three fundamental errors.
First, it said that between 1955 and 1971 the population would increase by 4½ per cent. This underestimated fertility, because the population increase is actually about 7 per cent. Secondly, it reckoned that the retirement rate among doctors would not be significantly affected by the commencement in 1958 of payments under the National Health Service Pension Scheme. In practice, a large number of doctors retired in 1958. Thirdly, it suggested the migration of

doctors was small and would decline. In practice migration is much greater than expected, and when Dr. John Seale, who took part in the original research, said that 25 per cent. of the output of our medical schools was going overseas, he was not received with any graciousness by the then Minister of Health, who I have to admit came from these benches.
Our next problem is the lack of status in the medical profession. This is a particular problem for the key worker, the general practitioner. Another problem is that of rapid change. A general practitioner requires freedom to change and freedom to adapt to keep pace with the increase in medical knowledge and it is here that the State sometimes tends to prevent this happening.
One of the great problems that is now arising, and which will shortly be of interest to us in the House, is that from the end of the 'forties there has been a tremendous growth in the number of valuable drugs which have been produced by the pharmaceutical industry, and a considerable rise in the use of antibiotics which have saved countless lives. These drugs have changed the whole face of medicine and have made it extremely important to make an accurate diagnosis and provide effective treatment.
A further problem is that of centralisation. Far too many decisions in the Health Service are centralised in the Ministry in London. This causes delay, with all the problems involved in dealing with correspondence flowing backwards and forwards between the central Ministry and the periphery.
Then there is the problem of communications. Communications throughout the Health Service are bad. They are bad between the Ministry and the medical profession, and the present Minister has done well to send a letter round to general practitioners explaining some of the things that he has been trying to do. The Ministry needs to be more in touch with the profession. There has been a lack of communication between doctors, nurses and patients, and we all know of the development of the Patients' Association, which is keenly interested in everything that is going on in the Health Service today.
There has been a breakdown in communications between the Ministry and private enterprise, such as the pharmaceutical industry. These two bodies have


clashed in past years. Last but not least, there has been a clash between the public health service and general practitioners. It is only in certain areas that the public health service is co-operating with general practitioners and vice versa. Far greater co-operation of this sort is needed.
I want to sketch some broad outlines of a possible Conservative solution for the future. I hope that some of my ideas will be acceptable to hon. Members opposite. In our rethinking of the general practitioner service and the Health Service we must cater for maximum individuality, by which I mean that the Health Service should cater for the individual needs of the doctor and the patient. It is undesirable that either should be forced to conform to a pattern which does not suit his individual personality or requirements.
It has been suggested that many younger doctors would prefer a salaried service. That may be so, but that would not be acceptable to many older doctors, who fear that it might mean a return to the type of salaried service that they experienced in certain medical services of the Crown. They know that this type of service sometimes does not lead to the greatest efficiency or to the attraction of the best type of man to the job.
Therefore, let us have a little individuality, remembering that some doctors would like a salaried service, others would like to be paid per item of service, while the remainder would prefer to engage in private practice. Let the patients, too, have a choice. Some would prefer to go to health centre clinics which employed a salaried doctor, where they would benefit from all the modern advances in medicine. Some would prefer to have the personal service which can be provided in a doctor's surgery or consulting room. Some would like to have the time and convenience which is available in private practice.
Any such scheme must promote the maximum amount of social justice. The general practitioner service should provide standards of medical care for all members of the community irrespective of income or other personal circumstances. On the other hand, it would be undesirable to prevent those who wish to do so from paying for a better standard of medical care than it is possible to provide for everybody. Choice

is available in almost every field of life. We have choice in our transport system and in our entertainment. We can choose to travel by car or by public transport. If we choose public transport, we can then choose whether to go first-class or second-class. We can choose what theatre or cinema to go to, as far as our pockets will stretch. Cannot we apply this sort of thinking to the National Health Service?
Two other points should be remembered in our rethinking. As far as possible, expenditure should be individually controlled. This principle is based on the belief that it is undesirable to incur expenditure from public funds on items which can be financed equally well by the individual. It is desirable to reduce public expenditure and taxation to a minimum. In this connection, we should bear in mind the cost of the National Health Service. Any scheme that we have for the future should allow for the growth of medical science. This should be encouraged, and the National Health Service should provide fully for medical advances.
This is not a new problem. The Labour Party has identified itself with a comprehensive, free-at-the-time National Health Service, but I believe that the Prime Minister has already shown that he is capable of jettisoning what we thought to be Socialist holy writ in seeking realistic policies in defence and foreign affairs. He and the right hon. Gentleman will have difficulties with the Socialist blowhards, but cannot hon. Members opposite see that the National Health Service is in great danger unless the doctors' charter is accepted and an entirely new relationship is created between the State, the medical services and the general public?

7.45 p.m.

Mr. Laurence Pavitt: The hon. Member for Birmingham, Perry Barr (Dr. Wyndham Davies) has made a very wide-ranging and historical speech covering everything that was possible to mention on this subject. His was the first speech in this debate which, in my view, was very unconstructive. In these health debates speeches from both sides of the House tend to conform to a pattern, because we have a mutual interest in the subject. The hon. and gallant


Member for Ripon (Sir M. Stoddart-Scott) and the hon. Member for Birmingham, Edgbaston (Dame Edith Pitt) made contributions of a type which enabled us to get to grips with the problem.
The hon. Member for Perry Barr surprised me when he appeared to accept the diagnosis of a consultant surgeon on matters of psychology and motivation. This was a surprising change from normal medical practice. He wanted to know why this was the first time that doctors had threatened to withdraw on the question of salaries. I would tell him that the same thing happened in 1956 and 1957. In those days, however, there was an elder statesman of the B.M.A.—Dr. Solly Wand—who was able to make various moves to prevent a withdrawal of doctors' services. When the British Medical Guild was re-established it was just for that purpose, for the B.M.A. itself cannot act with legality in this way.
The hon. Member has gone over all the past history. I would remind him that in considering the Health Service the Conservative Government, during their 13 years of office, established two committees to study the N.H.S.—the Guillebaud Committee and the Willink Committee—and those two committees came to different conclusions. The purpose of Guillebaud was to find the N.H.S. too expensive; and the purpose of Willink was to find economies on the number of doctors needed. The Willink Committee found that there was a surfeit of manpower, but the Guillebaud Committee, which considered the problem objectively, came to the right answer, which was that we were not spending enough. The Willink Committee came to a wrong conclusion. Hon. Members on both sides had bemoaned the fact ever since.
One of the main reasons for the increase in cost in the whole of the general practitioner service was the adherence to the recommendation of the Spens Committee, which reckoned that the total income of a general practitioner from all sources before the war was about £850 and that when the National Health Service started it should be raised to £1,111. Do not ask me why the figure of £1,111 was chosen. This was subsequently doubled, after the Danckwerts Award, to £2,222, and subsequently again, to

£2,765, after various other awards. So as the total cost of the Service has trebled from its original estimate, so has doctors' pay.
But the hon. Member cannot get away with his method of costing without taking into account as a general background the rise in the cost of living and in prices generally, not to mention the fall in the value of the £ sterling. The Spens Committee first reported as a background to the Beveridge Report, and it came to conclusions about the future which were entirely outpaced by the way in which the economy has developed.
Turning to the charter that we have been discussing, I was reminded of a report of the B.M.A. annual conference last year, which appeared in The Guardian. That newspaper said:
Two voices are there
One is of a sage
The other of a harpy in a rage.
When I look at the charter this quotation would seem to be apt. The voice of the sage is certainly there.
Hon. Members who have spoken have pointed to the various things about which there is common agreement, the things that we want for the general practitioner. There is the whole question of adequate time and a reduction of lists. He should have the right kind of premises and equipment and co-relation and co-ordination with the social services. He should have time for refresher courses so that he can keep up to date, and ancillary help, so that, as a qualified man, he is not spending his time acting as a filing clerk or typing letters with one finger to hospital authorities.
My right hon. Friend has said that he would be only too pleased to discuss these things and here he is being consistent in that he made the offer since he has been Minister, especially in the letter sent to every general practitioner on 1st January, and in the speech on 27th July, which has been quoted by hon. Members opposite as well in speeches year after year when we were in opposition.
The difficulty is that the other voice is also there. It seems to me that the voice of the harpy says only one thing, "Money, money, money." This is the


problem. When we want to discuss the shape of a reorganised general practice to achieve the kind of service we desire, the discussions are drowned by raucous squeals that, first, we must discuss money. We should not forget that when the matter was examined by the Pilkington Committee against the background of other professions the general practitioners came fourth in the list of professions and other people who had to have a long period of training in order to qualify.
In the present argument doctors are making two points. One is that a good deal of their work is trivial in that they have to minister to the Monday morning malingerers, and so have to do a lot which is unnecessary. The other point is that they are of vital importance to the Health Service. I do not think that the doctors can have it both ways. If the work they do is something which anyone could do then they are not worth more pay. If, as I believe, the Health Service needs the general practitioner as its basic and focal point, then the reorganisation of the practice and the increase in the amount of remuneration become relevant issues.
I should make it abundantly clear that I have no interest in this matter. It may be recalled that before I became a Member of Parliament I was the national organiser of the Medical Practitioners' Union, one of the bodies which has been mentioned in this debate. I ceased that employment on 8th October, 1959, because it was a condition of my appointment that I should no longer remain a member of the staff on becoming a Member of Parliament, because the organisation is non-political. I have received no brief from the union at any time during the last five years. When I have contributed to such debates as this, what I have said has been all my own work, or perhaps I should say all my own homework.
I wish to make clear that I am not speaking from the point of view of the union when I say that I believe that the general practitioner is right to demand his proper place in the Health Service. It is a conclusion at which one must arrive if one considers how, constructively, the Health Service could be improved.
In the redevelopment of general practice there must be the investment of large capital sums and this, I think, is a prob-

lem which the Government will have to face. We shall not be able to improve the shape of general practice unless we improve the surroundings in which the general practitioner works. This and the previous Government were committed to a capital expenditure of £750 million for hospitals. I believe that if a financial arrangement could be secured where about £150 million could be scheduled for the improvement of practice premises, either on the lines suggested in the charter or in other ways, to give the doctors the right tools to do the job, that would prove a more significant contribution than any talk about the doctors' income.
A good deal of the answer to the problem lies in capital investment, in forecasting the shape of general practice in the next five or 10 years and seeing that we put in the right kind of foundation upon which a reorganised practice can be built, rather than giving the doctors a bit of money from time to time to calm them down until the next time.
The fantastic thing about the B.M.A. negotiations—the B.M.A. was described by the hon. Lady the Member for Edgbaston as a tough negotiating body, and I agree—is that since 1948 nearly every demand which it has made it has eventually secured, but once the demand has been granted it has turned out that the doctors are not satisfied and this has lead to further problems. I look back to the whole history of the Pilkington Committee and the way it worked, and the independent Review Body. All these things resulted from the way in which doctors wished their pay to be dealt with. Even since we had the last debate in the House there has been the question of "strings" on the £5½ million and, once again, the doctors have had their way.
I agree with my right hon. Friend, I think it would have been a break-through if in this award we could have shown the way in which this terrible anomaly could be overcome where a doctor's expenses are paid in such a way as to give a direct incentive for him to give bad service. That could have been altered had the doctors accepted the recommendation of the Review Body in that respect and it would have been a step in the right direction.
We have talked of the way in which we could encourage group practice and I


hope that this part of my right hon. Friend's discussions will be fruitful. From the figures I find that in 1963 only 95 loans were made in respect of group practice, amounting to £608,000.
One problem which we have to fact is that doctors are inclined to over-state their case when discussing the problems of emigration and population. It was, I think, the right hon. Member for Wolverhampton, South-West (Mr. Powell) who analysed some of the figures which showed that out of 223 doctors recorded by Dr. Seale as having settled in Australia in the final analysis the figure worked out at 114. In the report made in 1964 from a paper by Brian Abel Smith it was shown that only 24 per cent. of doctors who emigrated came from general practice. A specific result of that study was that the generally held view that emigration resulted from dissatisfaction with general practice is not true.
The whole career structure of all doctors needs examination. A doctor may go into hospital service and even after being a registrar for four years wish to change. It is most difficult then to transfer from one section of the Health Service to another, and career prospects are such that it makes for frustration when the doctor cannot see how much further up the ladder he will get in the hospital service yet cannot see an alternative. This is more than a question of general practice

Dr. Wyndham Davies: I believe that it is true that in the present general practitioner service people go via this chain, from registrar or the hospital service, into general practice. Therefore, although they may not be a direct loss to general practice, they are, in fact, a loss, because they would have become general practitioners had they not gone abroad

Mr. Pavitt: I accept what the hon. Gentleman says. The point is that there is no real way in which he can become a general practitioner, other than by getting in as an assistant with a view. The whole question of entry into general practice is a vital point. The point made by the hon. Gentleman touches on this. This will surely be a matter which my right hon. Friend discussed with the doctors.
The total average increase in the number of patients last year for each

general practitioner was 22. The estimated increase for this year is 36. If that is multiplied by the 23,000 doctors, this means an additional work load of about the same amount as the number of patients—now about 640,000—who are on two doctors' lists. In view of the possible maximum of 3,500, and the present average of 2,300, this increase could be absorbed.
Bearing in mind the fact that in London the average list is still only 1,500 per doctor, I am not convinced that the addition of an extra 36 people is such an additional work-load that the doctors cannot cope with it. I accept the fact that, as people get older, and live longer this gives more work for the doctor. I think that it would be wrong, however, if the doctors overstated their case on these issues.
I hope that, when the Minister is discussing the other voice—the voice of pay—he will consider the other sectors in the Health Service. If there is to be a large increase in G. P. s' pay, the other people who serve the Health Service should also be considered. Occupational therapists and physiotherapists have a three-year training period, during which they get no pay at all. When they start practice, they get £623 a year, rising to £829 after seven years. A radiographer also trains for three years—not for the seven years which a doctor does—and he also gets £623 when he starts and £829 at the end of seven years. A staff nurse also trains for three years and receives only £773 per annum after she has been a staff nurse for five years.
If the Chancellor of the Exchequer allows my right hon. Friend any more money for the G. P. s, he should at the same time consider some of the other sectors of the Health Service if equity is to be maintained and the Health Service is to be fully staffed in all sectors.
I suggest that the present situation is not helped by the Press. I can recall the last debate, in which, in my view, my right hon. Friend made a most conciliatory speech. The right hon. Member for Bridlington (Mr. Wood) was most helpful, and the debate was constructive. Yet the headlines the next day would have led people to believe that my right hon. Friend was one of the most adamant members of the Government Front Bench, who had been throwing


everything at the Opposition and the doctors on which he could lay his hands.
During the brief interval in which I have been out of the Chamber, I have seen an evening paper, and the headlines indicate a great clash with the doctors. Yet we know, from the points of view expressed by the B.M.A. and by hon. Members opposite, that there is a large measure of agreement, and there is room in which we may be able to achieve a really good settlement. The Press are not being helpful in trying to represent this situation as a kind of contest between two heavyweights, a blow-for-blow battle between the Ministry and the doctors.
The point was raised by my right hon. Friend that, on 3rd March, the Daily Telegraph said, in a front-page story:
It was a considerable victory for the doctors. The independent Review Body had recommended that most of the increase should be used to encourage good medical practice. The British Medical Association would have none of this".
With this kind of approach, making this into a contest, it is very difficult to see how we shall get the best for the doctors.
We need to reorganise general practice. We need, in that reorganisation, not to impose anything on the doctors but to carry them with us. The only way in which we shall get preventive medicine is by an improved general practitioner service. This will mean the employment of all kinds of auxiliaries if the medical manpower is to remain at its present level—as it must—for the next seven years. It means adaptation by the doctor to the new circumstances. I believe that rather than an arbitration battle this must be a combined operation between the Ministry and the doctors, in which, I hope, success will eventually accrue.
One of my hon. Friends said that we are often inclined to lose sight of the fact that the Health Service is basically for the patient. There has only been one point of difference between the two sides of the Committee this afternoon, but it is a fundamental point. Hon. Members opposite consider that health is a commodity which can be bought and sold. Members on this side believe that health is something in which there should be no cash barrier between the prevention of illness and the person concerned. We do not regard health as a commodity, nor

as being subject to the law of the market place.
I believe that a good doctor has a vocation and that payment for service is not his main consideration. Of course he wants the right pay for the job, but I do not believe that it will be found by suddenly asking for a terrific increase on the scale mentioned today. I believe that his satisfaction will be found in an orderly, reorganised system of general practice

8.7 p.m.

Mr. William Shepherd: I look upon the speech of the hon. Member for Willesden, West (Mr. Pavitt) as being extraordinarily objective, in view of his antecedents. I accept the view that we have to preserve the National Health Service, and that the doctor has to play a more important part in it than he has hitherto. I admit that the development of medicine and the development of the Health Service has given rise to a considerable amount of discord among doctors, but I cannot accept much of what the doctors say about their own conditions.
I certainly cannot accept the way in which they have behaved in this dispute. It is distressing to me that professional men should behave in a manner which would be considered unsuited to the toughest of artisans. If we are to improve the standard of the medical profession, the medical profession must do something to improve its own standards.
There is, in the medical profession, an extraordinarily unsatisfactory situation. If one looks at the attitude of one part of the profession to another part, one sees in some sense the cause of the present difficulties. Take the relationship between the medical auxiliaries and the general practitioner. The auxiliary thinks that the medical practitioner is a man who does not know very much anyhow about some things and is overpaid. The medical practitioner tends to resent the efforts of the auxiliary, who, he thinks, does not know much about anything. The consultant looks upon the practitioner as a man who does not know much about medicine. The attitude of the general medical practitioner to the consultant is that the consultant is overpaid and enjoys advantages which he does not deserve.
If we were to relate this sort of attitude of mind to, say, the legal profession, if the managing clerk took the view of a solicitor or the solicitor of the barrister which is taken in the medical profession, that would be an unsatisfactory state of affairs
May I turn to some of the proposals which have been made? The first thing which we must try to do is to get training speeded up, because this is a manpower problem. The Minister, who has been extraordinarily conciliatory here today, would not be facing this demand but for the cut-back by the Willink Committee. He would not be facing this situation. The urgent problem is to get more men trained for medicine. After all, at £3,000 a year net one cannot claim that the medical profession is underpaid.
Indeed, if one looks at all other professions one sees that, on the whole, the medical profession is the highest paid of all professions. I agree that there is a tendency, because of a large demand in developing countries for medical men, for emigration to take place on a considerable scale. But this should not blind us to the fact that at £3,000 a year net we cannot say that the medical profession is underpaid.
Nor is it possible to be quite certain that all elements of the medical profession are overworked. I know of a general medical practitioner with over 2,000 patients who takes a part-time job four afternoons a week. I realise that hon. Gentlemen may be able to find other medical practitioners with the same number of patients who find it very difficult to meet all the demands made upon them when giving their full time, but it is not necessarily the case that all medical practitioners are overworked, or that they enjoy no leisure.
I think that general medical practitioners enjoy more leisure than ever before, because 75 per cent. of all medical practitioners in general medicine are either grouped under partnerships or in group practices, and in modern conditions this provides much more leisure for medical practitioners than ever before.
The real reason for discontent, apart from bad leadership and the fact that no section of the medical profession can agree with another section, is that the

doctor's position in general medical practice has deteriorated. He knows that probably 50 or 60 per cent. of his work could be done by people much less skilled and trained than he is. It is this lack of status which is the basic cause of the discontent—leaving out the question of bad leadership and confusion of ideas.
We should try to give the doctor a better position in medical society, because until we solve the problem of the medical practitioner having more status and doing more worthwhile things we shall never achieve the contentment which we want to see in the medical profession and which is essential to a good National Health Service.
I have hurried over these remarks because I know that a number of hon. Members opposite wish to take part in the debate. I hope that we shall not bow to any threat by the medical practitioners. I hope that the right hon. Gentleman will stand firm, knowing that the majority of people will be behind him in resisting any pistol at his head. This determination should not prevent our trying to take a realistic view of the Health Service after 17 years of experience. We must be flexible. We must look at the possibilities of change. We must try to upgrade the status of the medical profession. But let us not be stampeded by excessive demands which are not related either to the need of the profession or to the capacity of the public purse

8.14 p.m.

Mr. Raphael Tuck: May I first express my entire agreement with my hon. Friend the Member for Wandsworth, Central (Dr. David Kerr) in his view that medical practitioners should be given an additional appellation when speaking and being referred to in Parliament. He referred to them as honourable and qualified Members. May I suggest that such a Member should be referred to as an honourable and Hippocratic Member.
May I endorse what my hon. Friend said about the reasons for this vast increase in applications for prescriptions since the prescription charges were abolished. He said that this was due to the fact that previously many people could not afford a prescription. In my peregrinations around my constituency I


have many times been told by poor constituents, "We cannot afford the prescription charges". It has been said that people who live differently think differently, arid I can only suggest that hon. Members opposite have no idea of the straits in which some people live—people who cannot even afford two shillings for a prescription charge.
May I draw my right hon. Friend the Minister's attention to the situation of young resident doctors in hospitals? Already we have difficulties in staffing our hospitals with doctors. The output of the medical schools lags behind the increase in population. We have had a decline in the number of medical students in training from just over 14,000 in 1950 to just over 12,000 fairly recently. This situation has been aggravated by emigration. The hon. and Gallant Member for Ripon (Sir M. Stoddart-Scott) said that about 400 doctors a year were going abroad. I gather from Dr. Seale's writings that about 600 doctors a year are going abroad, which is five times as many as in the 1930's. Whereas in our country there is one doctor per thousand of population, one out of every 200 emigrants is a doctor. In the last 10 years, as was stated by the hon. Member for Birmingham, Perry Barr (Dr. Wyndham Davies)—accurately, too, this time—a quarter of the yearly output of the medical schools has gone abroad.
We might ask why this is? In my view the answer is not far to seek. I have gained my information from various young resident hospital doctors with whom I have discussed the problem. The conditions in which they work are hard—almost impossibly hard—and destroy the incentive to work. First of all, the living facilities are not adequate. If a doctor has a family, he cannot find living accommodation for them in the hospital, but has to board his family out and live in himself. What more natural than that these young doctors should seek to go abroad where they will have somewhere to live with their families?
A young resident doctor has no time off whatever. He works literally 24 hours a day, seven days a week. I am informed that he has his full duties during the day and is on call all night. Sometimes he is called out a number of times during the night. At 8 p.m. the casualty officers go off duty, but the casualty

department is open all night, and the young resident hospital doctors then have to do casualty duty in addition to looking after the beds in their own wards. In this way, very often a doctor has to work all night. They have no rest next day to help them get over the long hours they worked during the night. We, as Members of Parliament, feel—and, I may add, quite justifiably feel—that we are often kept here much too long into the night, but our plight is nothing compared with the plight of these young house doctors, who work day and night. Their living conditions are often appalling. I was informed that in one hospital the resident doctors lived in a tall building which had no lift. They were called out many times during the night. They had to come down from the top of this tall building and then return to the top again. One young doctor burst an important blood vessel in the heart because of the strain which he was undergoing in his medical duties, and he had to go to the United States to have it repaired.
I am sure that the majority of hon. Members would regard the money that these doctors earn as quite inadequate. During the first appointment, for six months, they receive £770 a year, less £175 for living in. That works out, based on the hours they have to work at l0d. an hour. Is it any wonder that they seek to go abroad? The only way that they can make ends meet may not be known to the House. If a patient dies and is cremated then apparently the young house doctor receives 2 guineas from the undertaker. Indeed, I understand that most of their income is derived that way, especially if they work in geriatrics. What a system to offer. Imagine putting a premium on death so that the more deaths there are the more money the young house surgeon gets and the better he is thereby able to make ends meet. I suggest this system be altered, and the sooner the better. Remedying the shortage of doctors will not be enough. It is imperative that we make the conditions in medical practice attractive enough to retain doctors after they have completed their training.
Without wishing to take issue with my right hon. Friend the Minister, I would place a slightly different slant on the reason why doctors have kept quiet for


so long and why they have suddenly come out and are vociferously objecting to their conditions. If I dared to give the reason, it would be that they have known for the last 13 years that it would be no use at all if they complained. They knew that they would get no hearing whatever from a Tory Government. It is only now, when we have a humanitarian Labour Government in power, that they feel that they will get a sympathetic hearing. It is not surprising that they should have waited for 13 years to make their cry heard

8.23 p.m.

Mr. Frederic Harris: Unfortunately, time does not permit me to comment on the last remarks of the hon. Member for Watford (Mr. Raphael Tuck), except to say that we did not have the threat of a doctors' strike during the 13 years of Conservative Administration.
In his remarks today the Minister was much more moderate than he was on the last occasion that he spoke. I welcome that tremendously, having taken a close interest in both debates. I was, however, concerned when he said, in effect, that whilst he was prepared to consider discussions on terms and conditions, apart from the injection of £5½ million there could not be any pay adjustment in answer to the doctors' request until 1st April, 1966. That was the impression I got from his remarks, although I asked in an intervention whether it would be possible to have any pay award subsequently backdated.
This aspect of the matter will cause tremendous concern among doctors, particularly doctors in Croydon. I naturally have a parochial interest in this matter. I want to make sure that the people of Croydon have doctors to whom to turn and I also want to ensure that Croydon's doctors will get a square deal which, in my opinion—having looked into this matter closely and spoken with many doctors in my constituency—I do not believe they are now getting.
All through these discussions Croydon's doctors have felt very strongly indeed about this matter and there is real concern about the present situation. I confess that I felt that, from the moderate

way the Minister put his case, that he might still be under-estimating the concern and anxiety that is felt by the doctors today. It is all very well trying to keep the atmosphere cool and calm. That is a good thing to do, but no hon. Member should under-estimate the problem we are up against. The anxiety among doctors now is that the impending negotiations should proceed on the basis of the charter. I stress the word "basis" in relation to the charter because no one in his wildest dreams expects that everything in the charter will be achieved. The doctors' further anxiety is that progress should be got under way as speedily as possible. They were hoping that the pay aspect would likewise be dealt with at a very early date, but it now looks as if they will have to wait until the details are settled before the pricing of their work can be undertaken; and this will, as the Minister confessed, take a long time indeed.
I appreciate the remarks made by hon. Members opposite that the Press have in some respects exaggerated the situation and that there have been some unfortunate reports. That has even happened in regard to the reception given to the charter. I can only say, however, that having looked into this closely in Croydon there is an overwhelming feeling there that the charter is a most sound basis for negotiation.
Speaking personally, I think that the reference in the charter to a five and a half day week is a little misleading. I think that the doctors were only trying to overcome the difficulty of wanting to compare their earnings with the money earned by those in other professions and to relate their hours of work to the hours of other workers. After all, are these not fair points to make?
All hon. Members will, I am sure, agree that the ceiling of 2,000 patients mentioned in the charter could not possibly be realised for a considerable number of years. The adverse comments sometimes made by the Government and certainly by Cabinet Ministers—including particularly the right hon. Member for Nuneaton (Mr. Cousins) the other day—will only harden the attitude of the doctors. It was a disturbing, silly, foolish and almost idiotic comment which he made the other day, if the reports in the Press were accurate. It is disturbing to


think that what is a proper and justifiable grievance by doctors on so many matters should have been subjected to some of these attempts to smear doctors by moralising at them. That should never have been done.
Not only is that not an effective way of dealing with the present situation but it should be remembered that we are at a time when delicate negotiations are taking place. I believe that so far about 70 per cent. of our doctors have handed in their resignations to be used, if necessary, by the British Medical Association. Presumably that number might yet be raised to about 75 per cent. That is a disturbingly high percentage of our total number of doctors and we must face the facts involved here. I cannot imagine the doctors easily deserting their leaders now, for if anything, they will prod them on to further efforts. The number of resignations in Croydon handed in is even higher than the national figure. I understand that it is about 80 per cent.
If these negotiations break down, and resignations are unfortunately advised by the B.M.A., I am convinced that the doctors are prepared to accept the consequences, both personally and in attending to their patients. Undoubtedly an insurance scheme for patients would soon be implemented. There would, of course, be a tremendous amount of hardship and concern, but in my opinion the doctors—certainly the doctors of Croydon—are prepared for this. They are concerned that if, unfortunately, they are pushed into taking this line of action, out of the ashes of the National Health Service an attractive family doctor service will eventually emerge. Everyone of us must, therefore, be most anxious that the negotiations ahead should prove successful, and not be protracted.
Many misleading statements have also been made about doctors' remuneration. Figures have been bandied about all over the place even in this debate. One gets the impression that doctors get about £80 or £90 a week. I have never heard such nonsense. There may be certain doctors who are particularly fortunate, but I know that most doctors in Croydon—very hard-working doctors, most energetic, with no spare time—are desperately worried financially at the present time.
I can give an instance that I can prove to the hilt. I have seen the figures relating

to the partnership of two doctors in Croydon. Between them they have 4,600 patients and, quite rightly, they find that they can find no time for anything else but looking after those 4,600 people. They do not have time to do hospital work, and they cannot take on separate private patients. For all this, they get a gross figure, between them, of £7,000—I have seen these figures myself—per annum. Of that £7,000, they are allowed £ £3,000 for expense purposes, but as their expenses are more like £3,400-odd it means that they must pay the other £400 from their taxed remuneration. The ultimate result is that, at the moment, they get about £1,800 a year, and then have to pay their own tax on that. That is a very difficult situation, especially for men working such hours.
I stress that that is typical of many doctors, certainly in the Croydon area, and it is something that we have to face up to. I therefore hope that these misleading statements about remuneration will be sat on once and for all—it is just not fair to the doctors. I also know, personally, of doctors in Croydon who are working on substantial overdrafts. They cannot go on getting these overdrafts, particularly when there is no early future increase to come along to help them out of their present difficulties. The situation is very worrying for them, and it is just not good enough. I sincerely hope that the Government will quickly put the matter right, because our doctors are a most vtial element in our National Health Service

8.31 p.m.

Dr. M. S. Miller: Unlike my hon. Friend the Member for Willesden, West (Mr. Pavitt), who declared that he had no interest in this mater now, I declare that I have an interest, and that is the interest of the medical profession in general—a profession of which I am a member. I usually leave the solution of medical problems to people more competent than I to deal with. I agree that the health of the nation is much too important to be left to doctors, but something is clearly wrong. We must find a solution based not on political advantage but on the advantage that will accrue to patient and to doctor alike.
I believe that the present crisis, if it is a crisis, is a complete indictment of previous Governments. The stand which the


doctors are taking and the action which they threaten are an indictment of previous Tory Governments who, in 13 years, did nothing to improve the fundamental structure of the general practitioner part of the Health Service.
For many years I have not seen eye to eye with many of my fellow general practitioners. I have regarded them as often being ill-informed about—even uninterested in—public matters, narrow in their outlook, confined almost entirely to their own sphere and conservative in attitude. But I must admit that they do a good job. Since the inception of the National Health Service 17 years ago our general practitioners have done credit to the whole structure of the medical profession, and if today they are coming forward with ideas that would, if carried to their logical conclusion, be disastrous to the National Health Service, there must he a good reason for it.
As I said, I did not see eye to eye very often with the members of my profession—indeed, I resigned from the British Medical Association and am not at present a member of that august body. I also agree that, to a very large extent at any rate, the doctors have themselves to blame for their present position. I do not disagree with this, but it must be remembered that many years have passed since the foundation of the Health Service was laid. It was only a foundation. A new generation of doctors is now taking over. They demand that fundamental changes be made.
I have made a few quick calculations of the cost of the latest demands or requests by doctors. On these calculations, it appears to me that the general practitioners are asking that the 9 per cent. of the total cost of the Health Service which at the moment is devoted to the general practitioner part of it should be increased to 12 per cent. Because the point of contact which most people have with the Service is with their general practitioner, I do not think that it is too much to ask that the country should devote 12 per cent. of the amount spent on the Service to the general practitioner part of it.
I do not think that comparisons are very helpful. To ask if one's doctor is worth £90 a week is just as irrational a question as to ask if the Beatles are

worth £1 million per year or, indeed, if a Member of Parliament is worth the salary he is paid. One can make comparisons with various professions. I take issue with hon. Members who bandy figures about which do not bear relation to the truth. The average practitioner under the National Health Service has a net remuneration, not of £3,000 a year but of nearer £2,000 a year, once the essential deductions are taken from his salary.
It is fatuous to talk about "the average practitioner", in any case. I would agree that there is such a thing as a statistical average practitioner, but he is just as fictitious as the average person. If a study were made of what the so-called average practitioner earned and from what sources he derived his income, it would be found that the majority of practitioners derive their income from only two or three sources of the pool—capitation fees, loading fees and maternity work. The majority of practitioners do not do private work, in spite of the facetious talk about the amount of money they can get from prescriptions. They do not do private work. The majority of practitioners do not get money from any mileage fund. They have nothing in addition to the three items I have mentioned.
On Sunday the Observer stated that the medical profession, by using its monopolistic position, was in danger of damaging its most valuable asset, public respect. I maintain that a good doctor will always command public respect. For him to receive adequate remuneration for the work he does can surely do nothing to damage this.
I was very pleased indeed to hear what my right hon. Friend said this afternoon. This will keep the door open for negotiations, which I believe will lead to fundamental changes being made in the structure of the Service. Whether we like it or not, we can no longer depend to such a great extent as we do at the moment on the doctor's sense of vocation. The doctor now sees himself as a worker, working for the good of the community, and he wishes, I think rightly, to obtain some of the fruits of development that other workers have.
We need a reshaping of the Service, for the benefit of both doctor and patient.


No service can be good if those who supply it are disgruntled, disillusioned or overworked. On the basis of the charter which the British Medical Association, of which I am not even a member, has put forward, I believe that the way is open for fundamental changes to be made which will indeed be for the benefit of everyone concerned

8.40 p.m.

Lord Balniel: I think the Committee will agree that this debate has taken place at an important moment in the history of the National Health Service and has proved very worth while. During the course of it we have had a series of constructive and temperate speeches which, I believe, the right hon. Gentleman the Minister of Health will appreciate as having contributed towards a happy solution of the unhappy dispute which exists at the moment

Mr. K. Robinson: indicated assent.

Lord Balniel: It has been valuable if only because it has given the right hon. Gentleman, to judge by the tone of his speech today, an opportunity of repudiating the assertion made by his hon. Friend the Member for Loughborough (Mr. Cronin) that he is psychologically ill disposed towards the medical profession. I can assure him that we on these benches have never believed that he is psychologically ill disposed towards the medical profession. We have felt that the rather provocative remarks which he has made during the course of the past month were no more than a mere façade and that behind the façade remained the old good will towards and interest in the National Health Service which he so long displayed when he was in opposition.
We on these benches are most anxious to contribute to a successful outcome of these negotiations. Of course, we are anxious not to say anything which could hinder such an outcome. But I think it would be wrong of us to mute criticisms where we feel criticisms are necessary, and I am bound to comment that we have some criticisms of the way in which these negotiations have been handled. Also we feel that some of the statements made by Ministers during the course of these negotiations have not contributed to the improving atmosphere which we

should like to see develop. On the other hand, we certainly accept that errors and faults of overstatement exist not only on one side in these negotiations.
Above all, what is needed is calm negotiation, quiet study of the complex, deep-seated and fundamental issues which are at stake and which are affecting the family doctor service. Calm negotiation is not assisted by the Minister of Technology choosing a party political platform in the middle of a by-election campaign declaring that the doctors are holding a pistol at the head of the Government by threatening to leave the National Health Service, and also saying that the doctors are doing their best to pull down the hospitals by this latest withdrawal threat. I can only say that I can think of no person in the entirety of the country less qualified than that particular right hon. Gentleman to criticise others who are discussing the possibility of withdrawing their labour from the service.
Nor do I feel that calm is developed by the Minister's remarks at Tiverton charging those members of the medical profession who complain about their working conditions with playing party politics

Mr. Robinson: indicated dissent.

Lord Balniel: We are glad that his subsequent speech, and, indeed, his speech today, have done much to redress the damage which was caused originally. Inevitably when statements of this kind are made the Press headline the event with—"Minister clashes with doctors" or, subsequently, "Doctors repudiate the Minister's charge." We would have liked to see reports of negotiations proceeding quietly ad constructively
We also have some criticisms of the way in which the right hon. Gentleman has handled these negotiations. The Review Body reported recommending an increase in remuneration of £5½ million, but it tied the greater part of this £5½ million to the reimbursement of practice expenses. The Government immediately, without consulting the profession, or without seeing whether this recommendation was in any way agreeable to the profession, accepted the recommendation. The Prime Minister, on the very selfsame day as the publication of the Review Body's Report, announced his acceptance and said that he would forthwith open


discussions to implement the recommendations.
It seemed to us from that very moment that the Government were heading straight towards a deadlock with the doctors' representatives. When in the last debate a month ago I queried the wisdom of the Government in taking this step, the Minister leapt to his feet and asked:
Is the hon. Gentleman really saying that one party to an arbitration ought to decide, before accepting, that the award is acceptable to the other side? This is a totally new doctrine. I have never heard it expressed before."—[OFFICIAL REPORT, 17th February, 1965; Vol. 706, c. 1274.]
In the special circumstances of this Review Body's Report, I certainly think that the right hon. Gentleman would have been wise to consult the profession. He ought to have said, "We as a Government are perfectly prepared to accept the overall sum of money recommended, but we are prepared to consult with the profession about the system of reimbursing expenses. It would have been wise to have done this from the first day, for two reasons.
The first reason is that it has always been assumed by previous Ministers of Health and the profession that the Review Body would handle only overall remuneration and would not recommend detailed systems of distribution. Even more important, the right hon. Gentleman would have been well advised to enter into negotiations right from the beginning, because his predecessor as Minister of Health gave on 17th September, 1964, a clear pledge to the profession that he would not impose a system of reimbursing expenses without their agreement. He said:
It has never been my intention to impose this new method of reimbursing expenses, which would cost the taxpayer several millions of pounds, if the profession does not like it.
In the event, the right hon. Gentleman, the present Minister, after a certain amount of ill will had been created, has taken our advice and withdrawn the strings. He has done what, when we debated the matter last month, he said was not open to him to do

Mr. K. Robinson: The noble Lord, of course, is giving rather a traversity of what has happened. The Government accepted the Review Body's award and

accepted an amended form, if hon. Members like, of the same award after the amendment had been made by the Review Body. What the Government did in the first place was not to impose anything on anybody. We accepted the recommendation of the Review Body and we did exactly what we were asked to do by the profession before that award was made. The profession said:
We are equally confident in assuming that the Government will accept and act promptly upon any recommendation which the independent Review Body may make.
Is the noble Lord complaining that we did precisely that?
To deal with the other point about the scope of the Review Body, what the noble Lord said about its being limited in terms to quantum of remuneration is in contradiction with the profession's evidence to the Review Body, which asked the Review Body to change the nature of the pool, and also said on the ancillary services that if they could not make progress with the Government they would have no alternative but to refer the matter to the Review Body

Lord Balniel: My main point was to express pleasure that the right hon. Gentleman had withdrawn the strings, which we asked him to do and which he had refused in the last debate. When the profession said that it was anxious for the Minister to accept any recommendations made by the Review Body, it was not then within its comprehension that the Review Body was likely to make a recommendation involving a distribution of the overall sums of money which it would propose. But we do not wish to argue too long on the details of negotiation. The important fact, which we welcome, is that the right hon. Gentleman has now withdrawn the strings from the recommendation and the possibility of fruitful negotiations is now before him.
If I may say so, the right hon. Gentleman, immediately after the stage to which I have just referred, put himself quite unnecessarily in a further difficulty. On 8th March, the general practitioners' representatives published their charter for the future of general practice. This charter covers the fees which the British Medical Association considered desirable. The Minister considers that its calculations are unsound. On 10th March, only two days after publication of the charter,


he held a Press conference contradicting the doctors' figures and giving what he considered was the cost of implementing the charter. At once, the right hon. Gentleman was accused, I think too harshly, by the doctors of issuing a tendentious and inaccurate statement.
Surely if he is engaged in serious complex negotiations of great importance for the future of general practice, and if there is a disagreement on the facts, the Minister would have been well advised, instead of rushing into a Press conference and publicly contradicting the doctors' representatives, to set up a working party to agree on the facts. Then, if no agreement were forthcoming, he could have held a Press conference subsequently. In fact, his action was, within two days of publication of the charter, to hold a Press conference and only subsequently to establish a working party to reach agreement on the facts. We were glad to hear from him today that agreement has now been reached on what would be the cost of implementing the charter.
I turn now from what I regard as the unhappy past. We very much welcome the willingness which the right hon. Gentleman is showing in discussing the various fundamental suggestions put forward in the charter. I echo the words of my right hon. Friend the Member for Bridlington (Mr. Wood), that we hope that the medical profession will take heed of the Minister's words and ponder long before urging their representatives to bypass the Review Body. Although we can understand the sense of frustration in the medical profession today, we believe that, in the long term, the existence of a Review Body, independent of the Government, is a source of great strength to the profession.
Obviously, we hope that, on the purely financial side, the Minister will manage to reach a settlement. If he can generate mutual good will—and I believe that he can by demonstrating beyond a peradventure his positive determination to seek a new satisfactory contract of service—we can be optimistic that he will reach a satisfactory financial arrangement. The fact that he has withdrawn the strings from the £5½ million might well prove to be the basis of an interim financial settlement. Then he can turn his attention to the drawing up of a new contract of service.
But, whatever financial settlement is reached, it must not be allowed to mask the fact that the present discontent centring around remuneration is only a symptom of a far more serious illness afflicting general practice. The focal point of discontent today is remuneration, but if treatment is only given to this symptom, if the right hon. Gentleman only reaches a financial settlement, he may truly be securing a temporary improvement in the well-being of general practice, but it will only be a matter of time before the real illness breaks out again.
The surge of discontent and disenchantment among doctors with the National Health Service reflect two things other than remuneration. They reflect a deep-seated failure to develop proper terms of service and conditions for family doctors. They also reflect, admittedly a very longstanding, failure to integrate the family doctor service into other parts of the National Health Service—the hospital service and the local authority health service. The Minister will be able to stave off a massive withdrawal of doctors from the National Health Service only if he can indicate that these two other matters will receive urgent and positive study. I believe that his speech today will have gone a long way towards reassuring doctors that he is urgently studying these other aspects of their problem.
Now I come to the integration of the family doctor service with the other parts of the National Health Service. Every report of significance—be it the Hospital Plan or the Health and Welfare Ten-Year Plan, or the extremely important Gillie Report—has stressed the need for closer integration of the three parts of the National Health Service. Following the Gillie Report, in October last year, the Ministry and the profession set up under Professor Butterfield at Guy's Hospital a general practice research unit. I want to quote words which appear in an article, written by Dr. Robert Smith, who is now head of the unit, which appears in the Guy's Hospital Gazette this month:
The future of general practice cannot be planned in isolation. Tripartite medicine belongs to the past and has little place in the future health arrangements of new developing areas.
With this categoric statement that tripartite medicine belongs to the past, I


find myself in complete agreement. None the less the framework of the National Health Service is based on tripartite structure. I hasten to say that this is not an argument for centralisation but an argument for integration of the three parts of the Service. The danger is, however, that whilst tripartite medicine belongs to the past, the family doctor service, instead of being integrated with the other two parts, may be squeezed out of existence altogether in a medical world of increasing specialisation and of astonishing advance in medical science and technology.
It is this uncertainty about the future of general practice which lies at the heart of the worries of general practitioners. Already in the United States the family doctor service has virtually disappeared. It would be tragic were that to happen here. I do not want to elaborate on this theme of integration now, except to say that integration, on the one hand, should take the form of the family doctor, perhaps working in a group practice, supervising a team of midwife, health visitor, home nurse and welfare worker. On the other hand, it should take the form of general practitioners being given proper access to hospital beds, to hospital diagnostic facilities and to hospital X-ray facilities. It could also take the form of general practitioners being given a proper place in psychiatric hospitals.
I should like briefly to refer to terms of service. The right hon. Gentleman has the task not merely of finding a solution to the pay dispute but of tackling the fundamental wrongs in our family doctor service. This means that he must evolve a new contract of service. In his search for a new contract of service, the time is right for him. The doctors are anxious for such a contract. The interest of patients demand it. It is, therefore, incumbent on the right hon. Gentleman positively to search for such a new contract.
Although we hope that a massive withdrawal of general practitioners can be avoided, if the right hon. Gentleman cannot find a new contract of service there will inevitably be a continued splintering away of doctors from the general practitioner service, some emigrating, others going into private practice. Most

important, these will be the youngest and the most enterprising doctors. Also the most acute problems will arise in industrial areas.
In seeking a new contract of service, the right hon. Gentleman should try to achieve a greater flexibility than now exists, greater flexibility in methods of payment and greater flexibility in methods of financing practice premises. The family doctor service in Belgravia is very different from the family doctor service in some industrial areas. The family doctor service in industrial areas is far removed from the quiet rural practices in which other family doctors undertake their tasks.
It would be a bold person who could point with any certainty to what method of payment we should try to lay down for the long term future. We should try to give doctors the security which they have under the present pooling system. It is essential that we give them clinical independence; we must reward their energies and ability and industry, and the contract of service must be financially feasible and professionally satisfying.
What we from these benches ask is that the Minister should consider putting into practice a series of alternative pilot schemes. One scheme could be based on a capitation system and another on an item of service basis. The Minister should also perhaps consider a contract of service based upon salaries, although in saying that we from these benches would like to emphasise that there are profound disadvantages for the medical profession in deciding in favour of a salaried service.
We also want to see a flexible approach to the financing of practice premises. We believe that there is a great deal of merit in the independent corporation which is suggested in the charter. Such an independent corporation could lend money to doctors to be repaid at fixed rates of interest so as to enable them to purchase modern practice premises. It could itself purchase premises to lease or sell to groups of doctors. Alternatively, such an independent corporation could actually build modern practice premises and sell or lease them to groups of doctors.
I should like to end by reiterating the theme which I have tried to develop. This dispute is most certainly not only about


remuneration, vital though remuneration is. It is not only about financing practice premises. It is a question of restoring the professional status which should attach to the family doctor service and which is not provided for by the existing contract of service between doctors and the National Health Service.
I should like to end by quoting from a letter written to me by a doctor in my constituency—a doctor in Welwyn Garden City. I quote from it because I think it emphasises that money and buildings, although important, are by no means the core of the problem facing the Minister. This doctor writes to me as follows:
Reading the debate"—
that is, last month's debate—
 in full, it was most interesting to see how many points of view were mentioned. I could add much more, but the only point I would make is that even in a town such as this"—
Welwyn Garden City—
where we have group practice with full rota arrangements, ancillary help, first class liaison with hospital staff and facilities for carrying out our own investigations so that probably there is not a better place to practise in Great Britain, the feeling of desperation is such as to produce a practically unanimous vote last Thursday evening
that is, a vote to hand undated resignations to the doctor's representatives.
He continues:
May we all hope that sufficient progress tray be made in the negotiations with the Minister that this crisis may be turned to the advantage of everyone rather than bring such a service to an end".
This constructive attitude is, I believe, echoed by doctors throughout the country. We on this side certainly echo what he says and express the hope that this crisis may be turned to the advantage of a service of which this country can be truly proud

9.1 p.m.

The Secretary of State for Scotland (Mr. William Ross): This House is indeed a strange place. We have had debates when the House was crowded with Members shouting at one another and outside the people were not the slightest bit concerned about what was going on; we were out of touch with the people. But I think that the sober, quiet and constructive tone of this debate shows that certainly on this occasion the

House is reflecting the concern which the nation feels for the future of the National Health Service, and particularly for the future of the family medical service.
The tone was set by the right hon. Member for Bridlington (Mr. Wood). He made a speech that was typical of him. It was constructive, thoughtful and generous to my right hon. Friend the Minister of Health. I think that he got right to the nub of the frustrations and, from that, to the dangerous consequences which might arise from impatient and ill-considered actions. There is a dilemma for doctors. While tremendous changes have taken place over the years, not just in the medical service but within the National Health Service as a whole, in treatment, in drugs and in the appliances which are available, there have been an unchanging contract and terms of service which have given the general practitioner the feeling that he is being squeezed out and that his valuable training, ability and skills are not being properly used.
It is these changes which lead us all to believe that it is not really money that matters. The trouble is that we all say it is not money that matters and then start talking about money. I thought that the hon. Member for Hertford (Lord Balniel) was most unfair to my right hon. Friend, particularly in his criticisms of our attitude to the Review Body. The whole purpose of the Review Body was to get an authoritative and independent consideration of what was involved in relation to remuneration, which would be accepted. To suggest that before it is accepted the Minister should see whether the profession wants it is disgraceful

Lord Balniel: rose—

Mr. Ross: Just a minute. The hon. Gentleman had a little more than his time.
Paragraph 436 of the Royal Commission's Report which gave rise to the Review Body says:
But we believe that seven people such as we have in mind will make recommendations of such weight and authority that the Government will be able, and indeed feel bound, to accept them. This procedure will in fact, therefore, give the professions a valuable safeguard. Their remuneration will be determined, in practice, by a group of independent persons of standing and authority not committed to the Government's point of view.


It goes on to say that in the interests of all concerned the Government should give their decision on the recommendations very quickly.
I think I am right in saying that there have been five reports from this Review Body. It is the Prime Minister to whom this body reports. Did the previous Prime Minister refer these matters to the profession?

Lord Balniel: The reason why I suggested that the Minister would have been well advised to consult the profession was because his predecessor had given a categoric assurance that he would do so. Surely in those circumstances it would have been wise to consult the profession?

Mr. Ross: The hon. Gentleman must realise that one cannot adopt a procedure like that without destroying the authority of the Review Body, which the right hon. Gentleman said was one of the things which must be retained. I thought that the right hon. Gentleman was very wise when he counselled the profession that in the long term it would not be to its advantage if the Review Body was by-passed.
Even worse than by-passing the Review Body is to send something to it and then to say "It does not matter what you say. Your authority does not count for anything". We cannot make progress on those lines. We all appreciate the difficulties. We all appreciate the dangers that are inherent in this, because we might easily destroy something which has been built up and accepted by the people of this country, and virtually taken for granted, namely, the worth of the Health Service.
Only one hon. Member today has criticised the Health Service lock, stock and barrel. He is the hon. Member for Birmingham, Perry Barr (Dr. Wyndham Davies). I am sorry that he is not here. He is a brave man. I think that his majority is about 300. However, there is plenty of time—four years—before the next election, so perhaps he can work his passage back. The hon. Member for Croydon, North-West (Mr. Frederic Harris) was another doleful pessimist, but he took it for granted that the negotiations would go on.
The negotiations can go on only if we get the feeling of harmony—and this was

appreciated by the right hon. Gentleman and by most hon. Members who took part in the debate—which can come from the letter sent yesterday by my right hon. Friend. This is not merely a question of money. Many other aspects of the problem must be considered. We must consider how to make the best use of the valuable service given by general practitioners. Reference has been made to migration, to overwork, to the conditions in which they work and to how best to use them. Surely these are matters for negotiation.
We have not been entirely idle in these matters. We have been pressing the question of group practice for a long time. We have been pressing the question of health centres and diagnostic centres, such as we have in Edinburgh. I wish that it was better used. We have one in Stranraer, which was built at the request of the general practitioners. This is the point about the acceptance of the principle of negotiation, because in Stranraer—a town with which most people will be familiar, if only because it is the place from which the Irish boat sails from Scotland—this health centre is used to the great advantage and general satisfaction both of the profession and the patient.
We are building a new town at Livingston and are already working out the basis for a district hospital with a series of district health centres.

Mr. William Baxter: rose—

Mr. Ross: My hon. Friend is going to tell me what has been done in his own area

Mr. Baxter: I am not, but I could quite well tell my right hon. Friend that. I want to remind him that since the inception of the National Health Service it has been the responsibility of succeeding Secretaries of State for Scotland to provide health centres throughout Scotland. In that respect the relevant Scottish Act differs from that which applies to England, under which this task is the responsibility of local authorities. In many areas of Scotland, however, local authorities have been compelled to build clinics for the doctors—which they use at a very low rental—


simply because succeeding Secretaries of State have not carried out their duties

Mr. Ross: I can assure my hon. Friend that we are now actively discussing progress along these lines with the doctors. I was glad to hear the speech of my hon. Friend the Member for Glasgow, Kelvingrove (Dr. Miller), who has great experience not only of medicine but, as a Member of Parliament, of an area that has been extensively redeveloped. In that connection I would point out that in the redevelopment areas in Glasgow we are discussing this question with the profession on the basis of providing a series of health centres from which general practitioners can work much more effectively.
The hon. Member for Birmingham, Edgbaston (Dame Edith Pitt) has experience of this subject in relation to both of the Departments to which she referred. She talked about the question of registration. As she knows from her own experience, it is not the simplest of matters to get this right, but I can assure her that my right hon. Friend has already had discussions with my right hon. Friend the Minister of Pensions and National Insurance on this very matter, and in relation to her suggestions. The hon. Lady's contribution was one of the valuable ones we have had today. I do not know whether I like her better when she is speaking on these matters or when she is decorating the Chair.
The hon. Member for Cheadle (Mr. Shepherd)—and he has gone, too—suggested that we should speed up training—my right hon. Friend covered this matter—and rightly referred to the fact that we are now paying for mistakes that were made in the past. It is amazing how every one agrees that the acceptance of the Willink Report was something for which we are now paying. I hope that hon. Members opposite will be a little more patient with my right hon. Friend. Since the mistake was made by another Government in 1957 the blame should not all be laid upon my right hon. Friend's shoulders a few months after he has accepted responsibility.
I was interested in the point the hon. Member made about status. This is something that the doctors do have with the public. Indeed, they have more than status, more than just confidence, for the

public rely more than ever on their family doctor. They rely on him more than on anyone in the medical profession, and so it is desirable to advance the family doctor as far forward into the hospital as possible. It may well be that lack of status comes from the change, to which I and others have referred earlier, within the medical profession—the change of emphasis taking place with the development of the Service. Surely in our negotiations we could come to satisfactory arrangements over this. But we can do so only if we start the negotiations. Arising out of what has been said today by my right hon. Friend, I hope that we shall reach that position.
The hon. Member for Croydon, West, I think it is—

Mr. Frederic Harris: It is Croydon, North-West.

Mr. Ross: The hon. Member for Croydon, North-West—why should I forget the North?—seemed to suggest that because he spoke quietly, because he spoke in such a way that no one could take offence at anything he said—it is difficult for a politician to do that, we get into trouble even by keeping quiet, just by a twitch of the eyebrows—my right hon. Friend underestimated the concern that there is in the country. Far from it. It is because he appreciates that concern that my right hon. Friend spoke as he did. Because he appreciates the concern, he has taken the opportunity today—thanks to the decision of the Opposition to use this day in this way—to make a progress report. I think it desirable that the public should know all the facts and figures and I am surprised that the hon. Member for Hertford should have taken my right hon. Friend to task because he held a Press conference. What had happened before that conference? There had been days of continuous Press conferences and statements made by the doctors. Surely my right hon. Friend was entitled, if only because of the right of the public to accurate information, to draw attention to the fact that there was a discrepancy of between £5 million and £10 million—an underestimate—in relation to the cost. I am surprised at the hon. Member. He must have written his speech before he heard the speech made today by my right hon. Friend. This point was covered—

Lord Balniel: rose—

Mr. Ross: No, I cannot give way. The hon. Gentleman had four extra minutes and he knows it. The chances are that, if I give way, by the time he sits down the time will be gone.
My right hon. Friend covered this matter and pointed out that as a result of the two sides getting together in quiet negotiation in the past few days they had agreed the figure of the cost. Let us forget the water that has gone under the bridge. Let us appreciate exactly what is at stake for the doctors, for the public and particularly for the patients. It is desirable that we should have these negotiations. It is desirable that the profession should know the extent to which these negotiations can go forward from now, and that it should appreciate exactly that point which my right hon. Friend has made with a firmness which has been appreciated on both sides of the committee, that the quantum, the aggregate in relation to remuneration, is something which should be referred to a body as authoritative as the Review Body.
I think that the advice of the House would be that the doctors would do well to study the letter which has been sent to them by my right hon. Friend, and to appreciate that there is therein the opportunity not only to settle the immediate difference but to go ahead and create a structure within which we can draw from the lessons of the past and which we will be able to mould properly in the future without waiting for crises to come to boiling point.
I have been reading something to which I think the attention of the Committee should be drawn. It is the Lancet for 28th July, and it says:
The eyes of the public are on the movements of the profession, and duly ought they to appreciate any exertions made by medical men to benefit mankind. Those who are aware how badly rewarded, in a pecuniary point of view, are the hardworking general practitioners will do so.
That is from the Lancet of 28th July, 1849. With the passing of a century the position of complaint has not changed. I think, however, that we may well have the opportunity now to put this right, and not merely to put it right for a day but to put it right for, I hope, a generation. We should remember that the generation which is now getting the benefits of the Health Service is a genera-

tion which has never known the kind of unequal service which we had before the war. When I hear a Member of Parliament suggesting that we should compare the provision of health and treatment with the provision of entertainment, I begin to wonder how he got here at all.
The Health Service is part of our heritage. It is part of the challenge that we should, in the negotiations which will come, ensure that the Health Service will stay and will flourish

Question put and agreed to.

Resolved,
That a sum, not exceeding £1,915,906,800, be granted to Her Majesty, on account, for or towards defraying the charges for the following Civil Departments and for Defence (Central) for the year ending on the 31st day of March 1966.

The CHAIRMAN then proceeded, pursuant to the Order of the House this day, to put severally the Questions, That the total amounts outstanding in such Estimates for the Defence (Royal Ordnance Factories), Defence (Army) Purchasing (Repayment) Services and the Defence (Air) Services for the coming financial year as have been put down on at least one previous day for consideration on an allotted day, and the total amounts of all outstanding Estimates supplementary to those of the current financial year as have been presented seven clear days and of all outstanding Excess Votes be granted for the Services defined in those Estimates, Supplementary Estimates and Statements of Excess.

DEFENCE

ROYAL ORDNANCE FACTORIES

That a sum not exceeding £1,500,000, be granted to Her Majesty, to defray the expense of operating the Royal Ordnance Factories, which will come in course of payment during the year ending on the 31st day of March 1966.

Question put and agreed to.

DEFENCE (ARMY)

PURCHASING (REPAYMENT) SERVICES

That a sum, not exceeding £2,000,000 be granted to Her Majesty, to defray the expenditure incurred by the Army Department on the supply of munitions, common-user and other articles for the Government service and on miscellaneous supply, which will come in course


of payment during the year ending on the 31st day of March 1966.

Question put and agreed to.

DEFENCE (AIR) ESTIMATE, 1965–66

That a sum, not exceeding £423,210,000, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March 1966, for expenditure in respect of Air Services, viz.:-


Vote
£


1. Pay etc. of the Air Force
140,210,000


2. Reserve and Auxiliary Services
770,000


7. Aircraft and Stores
281,000,000


8. Miscellaneous Effective Services
1,230,000



423,210,000

Question put and agreed to.

CIVIL ESTIMATES, SUPPLEMENTARY ESTIMATES, 1964–65

That a further Supplementary sum, not exceeding £69,080,000, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1965, for expenditure in respect of the following Supplementary Estimates:—

CIVIL ESTIMATES


CLASS I



£


1. House of Lords
26,000


2. House of Commons
429,000


3. Treasury and Subordinate Departments
452,000


3A. Department of Economic Affairs
342,000


6. Customs and Excise
2,207,000


7. Inland Revenue
2,300,000


8. Exchequer and Audit Department
78,000


9. Civil Service Commission
31,000

Question put and agreed to.

DEFENCE

ROYAL ORDNANCE FACTORIES

That a supplementary sum, not exceeding £1,700,000, be granted to Her Majesty to defray the expense of operating the Royal Ordnance Factories, Which will come in course of payment during the year ending on the 31st day of March, 1965.

Question put and agreed to.

DEFENCE(AIR) SUPPLEMENTARY ESTIMATE, 1964–65


That a Supplementary sum, not exceeding £1,000, be granted to Her, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1965, for expenditure beyond the sum already provided in the grants for Air Services for the year.


SCHEDULE




Sums not exceeding




Supply Grants
Appropriations in Aid


Vote
£
£


3. Air Force Department Headquarters
…
450,000
—


4. Civilians at Outstations and the Meteorological
Office
…
1,250,000
*— 100,000


5. Movements
…
Cr. 800,000
1,400,000


7. Aircraft and Stores
…
Cr. 2,099,000
599,000


8. Lands, Buildings and Works
…
—
*— 400,000


9. Miscellaneous Effective Services
…
100,000
*— 300,000


10. Non-effective Services
…
1,100,000
—


 Total, Defence (Air) (Supplementary), 1964–65
…£
1,000
1,199,000


*Deficit.

Question put and agreed to.

CIVIL ESTIMATES (EXCESSES), 1963–64


That a sum, not exceeding £832, 896 5s. 0d., be granted to Her Majesty, to make good excesses on certain grants for Civil Services, for the year ended on the 31st day of March, 1964.


Schedule


Class and Vote



Excess Votes



£
s.
d.
£
s.
d.


CLASS II








2. Foreign Grants and Loans


Subhead B. 4.—Somali Republic (Grants in Aid):


Excess Expenditure
239
1
7





Less—Net savings available on other subheads
229
1
7









10
0
0


CLASS IV








11. Roads, etc., England and Wales








Excess Expenditure
912,049
4
4





Less—Appropriations in Aid
79,182
19
4









832,866
5
0


CLASS VI








12. Scottish Education Department (Teachers' Superannuation)








Excess Expenditure
44,868
17
17





Less—Appropriations in Aid
44,858
17
0









10
0
0


CLASS XI








3. State Management Districts, Scotland








Excess Expenditure
1,328
6
8





Less—Appropriations in Aid
1,318
6
8









10
0
0


Total, Civil (Excesses)



£832,896
5
0

Question put and agreed to.

Resolutions to be reported.

Report to be received Tomorrow;

Committee to sit again Tomorrow.

WAYS AND MEANS

Considered in Committee.

[Dr. HORACE KING in the Chair]

Resolved,
That, towards making good the Supply granted to Her Majesty for the service of the year ended on the 31st day of March, 1964, the sum of £832,896 5s. be granted out of the Consolidated Fund of the United Kingdom.—[The Chancellor of the Exchequer.]

Resolved,
That, towards making good the Supply granted to Her Majesty for the service of the year ending on the 31st day of March, 1965, the sum of £70,781,000 be granted out of the Consolidated Fund of the United Kingdom.—[The Chancellor of the Exchequer.]

Resolved,
That, towards making good the Supply granted to Her Majesty for the service of the year ending on the 31st day of March, 1966, the sum of £2,726,447,800 be granted out of the Consolidated Fund of the United Kingdom.—[The Chancellor of the Exchequer.]

Resolutions to be reported.

Report to be received Tomorrow; Committee to sit again Tomorrow.

LONDON GOVERNMENT

9.35 p.m.

The Joint Parliamentary Secretary to the Ministry of Housing and Local Government (Mr. Robert Mellish): I beg to move,
That the London Government (Public General Acts) Order 1965, a draft of which was laid before this House on 10th March, be approved.
Those who took part in the debates on the London Government Bill will remember, among other things, that it was a long and detailed piece of legislation. It could hardly have been otherwise, because it was dealing with a subject entirely regulated by Statute in an area containing about 90 separate authorities with very different histories and powers.
The Act established a new pattern of authorities, with the Greater London Council exercising certain functions over the whole of Greater London, and the 32 London borough councils and the Common Council responsible for a wide range of services in their areas. A substantial part of the Act is taken up with

the allocation of functions between the new authorities. The powers and duties of the Greater London Council are set out specifically in the Act, and so are most of the major functions of the borough councils. In the case of the boroughs, however, there are two pieces of general machinery through which they may become responsible for other functions without the individual Acts in question all being itemised.
One of these is the fact that each London borough is covered by the expression "borough" where that is used in a Statute dealing with local Government. So where functions are given to boroughs generally they will now be assumed by the London boroughs as well. The other is the general formula, which is contained in Section 4 of the Act, which I will summarise by saying that the London borough councils inherit the powers of county boroughs where these powers are being exercised in the Greater London area.
The London Government Act provides for the possibility, however, that it may be desirable in some cases to give further powers to the Greater London Council or to the boroughs by the amendment of Public General Acts which have not been dealt with expressly in the London Government Act itself or where they are not translated by the general provisions I have mentioned. That is the purpose of the Draft Order before the House tonight.
This is not, of course, the only Order made under the London Government Act. Many have already been made and others will be laid before Parliament between now and 31st March. I would like, at this point, to pay tribute to the staff of my Department—who, I know, because I have been there for about five months and have seen them closely at work—for the tremendous industry and efficiency which they have had to apply to get these Orders laid before Parliament. We are very grateful, at our level, for the work they have done. These other orders deal with consequential and transitional matters and may be annulled by Resolution, but they do not need to be positively approved by the House.
The Order we are considering requires an affirmative Resolution because it gives the new authorities further powers under Public General Acts. I think that it will


emerge from my remarks that these further powers amount to no more than a minor tidying-up operation. There are six substantive articles and each deals with a different subject. They are set out in the chronological order of the Acts which they adapt, starting with the Game Act, 1831.
I confess that I did not know until recently that shopkeepers who sell hares, pheasants, grouse and other forms of game, must have a licence. They must, and these must be displayed outside their shops in the same way as licences to sell wines, spirits and tobacco. Throughout the country these licences are now issued by the borough and district councils. The London borough councils in outer London will inherit this function through the general provisions of the London Government Act, but in inner London, the present L.C.C. area, by an historical curiosity, licences are still issued by the justices. The effect of Article 3 is to make the law uniform throughout Greater London, so that all these licences will be issued by the borough councils or, in the City, by the Common Council.
Article 4 deals with the enforcement of the Acts and Regulations relating to the grading and marking of agricultural produce, with particular reference to eggs. In outer London, these enforcement duties will pass from the county councils to the London borough councils, but in inner London the wording of the earlier statutes does not bring the councils within the general formula of the London Government Act. Metropolitan borough councils and the Common Council already have these functions in inner London, and the Order merely transfers the function from the metropolitan boroughs to the inner London boroughs.
Articles 5 and 6 give the Greater London Council functions which local authorities possess generally throughout the country and which are available to the existing county councils in Greater London. The Physical Training and Recreation Act permits local authorities to provide playing fields and centres for athletic clubs or clubs with social or educational objects. Such powers are obviously relevant to the G.L.C.'s functions as a parks authority and as the education authority for inner London. The powers under the Road Traffic Act would permit the G.L.C. to arrange or

contribute towards road safety training and propaganda. The Greater London Council is the road traffic authority for Greater London, so this provision, again, seems clearly right.
Article 7 follows on the reallocation of functions in Greater London and also comes within the scope of the Order. The L.C.C. at present appoints one member each to the two training councils mentioned in the Order—one for training health visitors and the other for training in social work. It does so as an authority responsible for services in this field. The health and welfare functions of the L.C.C. will in future be exercised by the London boroughs and the City. Hence, Article 7 provides for the appointments to the two training councils to be made by the London Boroughs Committee, on which all the London boroughs and the City are represented.
The last article of the Order gives to the Greater London Council the new power contained in Section 6 of the Local Government (Financial Provisions) Act, 1963—an Act that was passed by Parliament during the same Session as the London Government Act. This is the power to incur expenditure on purposes not covered by other specific statutory authority where the Council is of the opinion that it would be in the interests of the area or its inhabitants.
The power is limited to the product of 1d. rate in any one year. This is, of course, a large sum in Greater London, but the Greater London Council will be the biggest local authority in the country—possibly in the world—with responsibilities to match, and I am sure that it is right that it should have a reserve power which, in 1963, was given to every other authority in the country. Had the London Government Bill and the Local Government (Financial Provisions) Bill not been before Parliament simultaneously I assume that the G.L.C. would have been given these powers at the time.
To sum up, this Order contains no new or startling proposals. It deals with some minor points that have emerged during the preparations for the changeover to the new system, now only a fortnight away. I do not intend to recall past controversies on London government, although I could take a long time over that tonight if it were in order—we had an echo of it earlier today—but would conclude by


extending my good wishes to the new authorities in the tasks that lie ahead of them

9.44 p.m.

Mr. Graham Page: I would add my good wishes to those of the Joint Parliamentary Secretary to the authorities which are to undertake the new London government. I would also add my congratulations to his Department for its industry in preparing these very necessary orders to bring that new form of London government into operation.
This is a Statutory Instrument which amends a number of Acts of Parliament. It is made in pursuance of Section 83(2) of the London Government Act, 1963. I commend that Section to the present Government. By reason of that Section, we have to have the procedure tonight of a draft Order to be approved by the House. In too many Bills which have been presented to us this Session the Government have sought to change previous Acts of Parliament merely by Statutory Instrument subject only to an annulment Resolution in the House. This is why I commend Section 83(2) to the Government, which obliges the Government when making an alteration in previous statutes to do so in the form of a draft Order. That is why we have this draft Order before us tonight.
The 1963 Act did, in Section 83(1) and in Schedule 17, amend a large number of Acts of Parliament. This was done in the Act itself, but it had this residuary subsection (2) which said that, if it was found expedient to amend any other Act to bring into operation this new London government, that could be done by bringing a draft Order before the House.
This draft Order deals with a hotchpotch of Statutes—game dealers' licences, grade designations for agricultural produce, recreational facilities, road safety promotion, the transfer of powers of appointing certain members to training councils, and also, in the last article, to which the hon. Gentleman referred, the transfer of the power of local authorities to spend a 1d. rate on matters which are of assistance to their area or to the inhabitants of that area.
The Joint Parliamentary Secretary said that it was very necessary for the Greater London Council, because it was such a large body—probably the largest local authority in the world—to have the power to carry out these functions by raising a 1d. rate. I wonder what he had in mind for these powers of the Greater London Council. I cannot quite visualise this from such a large body. These functions were more for local authorities at borough and county district level than for the Greater London Council. I cannot quite visualise any occasion on which such a large body would require to undertake these functions.
Article 3 deals with game dealers' licences. London has always been an anomaly in this respect. Originally, under the 1831 Act, justices had to issue these licences. This job was handed over to local authorities as long ago as 1894, except for London. Dealers in London were still left to go and get their licences to sell game from the justices. Section 4 of the 1963 Act succeeded in transferring that function in respect of the Outer London Boroughs, but failed to do so in respect of the Inner London Boroughs. If I understand it aright, that is why we have to have the Order.
When I first saw this, I thought that the provision had been brought to mind by Goldie the eagle, that the Government had suddenly thought—"Oh, dear, we must have the game licences correct in London". However, the hon. Gentleman mentioned the definition of "game" in the 1831 Act, which I have written down here as
hares, pheasant, partridges, grouse, heath or moor game, black game and bustards.
which I take it is no reference to the present Government.
It makes one wonder why we need to perpetuate these game laws and give local government employees the job of learning these ancient game laws from 1828 to 1906. Are there to be night courses for local government servants to learn how to issue the licences? The Joint Parliamentary Secretary laughs, but it is no easy matter to issue a game dealers' licence. The person issuing it must be dead certain that it is not being issued to the guard or driver of a mail coach or a stage coach or to a carrier or higgler. I have no idea what a higgler is, but the


clerks of the local authorities apparently must now solemnly ask each applicant whether or not he is a higgler before a game dealer's licence is issued to him. I would rather have seen the repeal of these rather stupid game laws instead of perpetuating them in this Order.
Article 4 relates to the enforcement of designation marks for agricultural produce, fish and eggs, which was always in the hands of the Metropolitan boroughs. It is now to be in the hands of the London boroughs, and quite rightly so. But I would have thought that Section 4 of the 1963 Act did this for the Outer London Boroughs. Article 4 is not restricted to the Inner London Boroughs, and it seems to me that so far as the outer London boroughs are concerned it is superfluous; but, at any rate, perhaps it removes doubt in covering all of the London boroughs.
Article 5 deals with the Physical Training and Recreation Act, 1937, concerning the provision by local authorities of gymnasiums, playing fields, holiday camps, camping sites and so on, and by paragraph (b) these powers are extended to the Greater London Council. However, there is no mention here of any of the London boroughs. Ought not the inner London boroughs to be mentioned there? I am not sure whether Section 4 of the 1963 Act places these powers with the London boroughs, and, of course, it is essential that these powers should rest with the London boroughs as well as with the Greater London Council.
I do not know whether the hon. Gentleman can give me an assurance that in some other parts of the London Government Act, 1963, the London boroughs have the power which is now given to the Greater London Council under Article 5(b). It is my recollection that many of these powers providing recreational facilities under the L.C.C. were contained in private Acts. I suppose that somewhere in the 1963 Act, or in some Orders, those functions which are contained in private Acts are transferred to the Greater London Council. I would not like to say where that is brought about, and I am sure that the hon. Gentleman cannot give me an answer off the cuff, but I am sure there are many recreational powers contained in private Acts.
Article 5(a) is rather peculiar. It refers to Section 4(3) of the Physical Training and Recreation Act, and that provision deals only with swimming

baths. Only in this one case in the whole of this Order do we find anything relating to the Greater London Council's education authority. The Inner London Education Authority is brought in to provide swimming baths. I am sure it has more power than that. Should it not have power to provide gymnasiums, clubs and so on—in fact, all the rest of the powers contained in the Physical Training and Recreation Act?
The education authority, of course, is very closely tied up with playing fields and gymnasiums, and, if it is given power merely to provide swimming baths, surely in many buildings there will be gymnasiums and all the rest of the facilities as well as swimming baths. Perhaps I have missed something here, but I have studied Section 4(3) carefully, and the additions which this Order makes to it, and it seems to me that the Inner London Education Authority is being given this very small power and nothing else.
Article 6 is concerned with road safety, a subject very dear to the heart of the Joint Parliamentary Secretary and myself in many debates in the House. Under Section 75 of the Road Traffic Act, 1960, which provides for road safety committees of local authorities and the dissemination of information and advice about road safety, these functions are given to the Greater London Council. I am in no doubt that the London boroughs already have these powers under the other provisions of the 1963 Act. Is it necessary to give these powers to the Greater London Council, and how is it intended to divide this road safety information and advice function between the Greater London Council and the London boroughs?
The Minister has a responsibility here. I am not just asking how the local authorities divide it between themselves, because under Section 75(3) of the Road Traffic Act, 1960, the Minister, if he is satisfied with what a London borough is doing about road safety, can say as he could say to the L.C.C., "Do not put in a county precept on that borough for road safety expenditure. The borough is doing enough for itself". I suppose that the same thing can be said by the Minister to the Greater London Council, but I do not know whether he can indicate what he has in mind for the Greater London Council


to do in road safety matters as opposed to what is being done by the London boroughs. If he gets more centralisation in road safety advertising I shall be the first to congratulate him. I have always thought that road safety advertising should be on a national basis rather than be in the hands of so many local authorities.
Article 7 provides for the appointment of representatives to the two training councils, the Council for the Training of Health Visitors and the Council for Training in Social Work. These appointments were in the hands of London County Council, and as the services will now be in the hands of the London boroughs it is right, as the hon. Gentleman has said, that it should now be the London Boroughs Committee which appoints the representatives to these Councils. But why are they only being appointed for six months? This seems a bit niggly. Surely they are appointed for a longer period than from 1st April to 30th September, 1965?
Incidentally, it was the Health Visiting and Social Work (Training) Act, 1962, which we are dealing with in Article 7, that authorised local authorities to promote research into any matter relating to the functions of local authorities under Part III of the National Assistance Act, 1948. Part III of that Act, as the hon. Gentleman knows, deals with the provision of accommodation, something which is very topical at present. Why is that not mentioned in this Order? I doubt whether it passes anywhere else under the Act, and since we are dealing with this 1962 Act could not we make clear that these powers of research into matters connected with Part III—very important functions of local authorities at present—are properly transferred to the local authorities?
I apologise for these piecemeal questions, but it is a piecemeal Order. I wonder how many more such Orders will have to be thought up. I admire the Department very much for its industry in producing them, but I hope that, in due course, these Orders will be consolidated into one, with an index to which we shall be able to turn to find our way about it and really to be able to understand it. With those piecemeal questions, I give the Order my blessing.

10.0 p.m.

Mr. Mellish: I am obliged for the opportunity to reply to the hon. Member for Crosby (Mr. Graham Page), who, if I may say so, continues the great effort which he showed when his party was in power. It must be conceded that, whenever there is a debate in the House on almost any subject and the hon. Gentleman speaks, one always feels that he has just come out of the Library with a mass of information, which he promptly throws at whoever happens to be at the receiving end. I hope that the hon. Gentleman will forgive me if I cannot answer all his questions "off the cuff". I shall do my best.
The hon. Member will be interested to hear something in reply to his question about game and the licensing arrangements which are now to be in the hands of the London boroughs. In one respect, I can relieve his mind straightaway. I understand that the bustard has been deleted from the list of saleable game by one of the Wild Fowl Protection Acts. I hope that that makes the hon. Gentleman feel better.
Whenever one examines laws of this kind, one gets bewildered. For example, if the Home Secretary considers the hackney carriage laws really strictly—I hope that I am in order here—he ought not to give a licence for any taxi unless it has a bale of hay in it. That is the law as it now stands. Whether some taxis would be helped by having a bale of hay in them, judging by the way they work, I am not sure. But there are anomalies of this kind, and in this case we have decided that a power which other authorities have had should be given to the inner London authorities.
The hon. Gentleman asked a question about Article 5 and the functions under the Physical Training and Recreation Act. The answer about the borough councils is "yes; they already have these powers under the London Government Act itself". Article 5 gives the Greater London Council functions which local authorities throughout the country possess under this Act. Swimming baths and the like are a public health function of boroughs. The Inner London Education Authority will, as an education authority, be given a measure of power and control in this connection because the


Greater London Council will inherit some of these powers.
The hon. Gentleman is quite right to say that he and I have had many debates on road safety in the past. I like to believe that the Greater London Council's function in this will be one of co-ordination. The Greater London boroughs will be small towns, or even large towns, in their own right, with populations of an average of 250,000. They are all in the process of appointing safety officers now. I like to believe that the London Boroughs Committee and the Greater London Council itself will co-ordinate their activities.
If I may say so, the hon. Gentleman's suggestion in this connection was very intelligent. I hope that the G.L.C. will take it up and ensure that the propaganda which is put out will have some uniformity and sense about it so that we do not have the sort of competitive race we sometimes have, some boroughs doing very badly and others doing very well. We should aim at the very best propaganda on road safety, and I believe that this is the sort of thing which the Greater London Council should do.
The answer to the hon. Gentleman's question on Article 7 is that the first members are appointed for six months and reappointments thereafter will be for three years. It was felt that there should be this interim period in which boroughs could make their adjustments, but, when September comes, the appointments thereafter will be for three years. I understand that the authorities concerned have been consulted and have agreed to this procedure.
I hope that I have succeeded to a large extent in allaying the hon. Gentleman's genuine fears. I much appreciate the endorsement which he gave to the work of my Department in this matter, which has been very hard and tedious. They have tried as best they can to secure agreement with everyone concerned, and to achieve that among the London boroughs and the Greater London Council is no mean achievement. By and large, it has been done and I am obliged to the hon. Gentleman for the support he is giving me in thanking them for what they have done

Question put and agreed to.

Resolved,
That the London Government (Public General Acts) Order 1965, a draft of which was laid before this House on 10th March, be approved.

LEE CONSERVANCY CATCHMENT BOARD

10.5 p.m.

The Joint Parliamentary Secretary to the Ministry of Housing and Local Government (Mr. Robert Mellish): I beg to move,
That the Lee Conservancy Catchment Board (New Functions of River Authorities) Order 1965, dated 1st March, 1965, a copy of which was laid before this House on 3rd March, be approved.
I must begin by reminding the House of the background to the Order. The Water Resources Act, 1963, established 27 river authorities to carry out water conservation functions conferred by the Act over the whole of England and Wales, except the Thames catchment area, the Lee catchment area and the London excluded area. They were set up by Order on 15th October, the first appointed day, and take on their full functions on 1st April, the second appointed day.
These authorities will also exercise the functions—fisheries, land drainage and prevention of pollution—formerly exercised by river boards, which will cease to exist on 1st April.
The Act offered the Ministers of Housing and Local Government and of Agriculture two courses for the Thames and Lee catchment areas and the London excluded area. The Ministers could have designated these as river authority areas under Section 10 and established ordinary river authorities in those areas. As an alternative, they are given power, by making an Order under Section 125 jointly with the Minister of Transport, to confer on the Conservators of the River Thames and the Lee Conservancy Catchment Board within their catchment areas all or any of the new water resources functions of a river authority. Section 125 also empowers the three Ministers to include in their Orders provisions altering the constitutions of the Conservancy and the Catchment Board
… in such manner as the Ministers may consider necessary or expedient.


Throughout the Parliamentary proceedings on the Act, it was made clear by Ministers that the intention was to take the second of these courses and to confer on the Thames Conservancy and the Lee Catchment Board all the new water resources functions of a river authority in their catchment areas. It was stressed that the constitutions of both authorities would need to be altered to take account of their extended range of functions and that their existing local enactments would need to be reviewed. I should emphasise that this course was accepted by both sides of the House.
In the Thames catchment area, the Thames Conservancy was given the new water conservation functions by Order last July, and at the same time reconstituted so that, as with river authorities, a bare majority of members are from the local authorities on whom the Conservancy precepts—the county councils and the county borough and London borough councils. An amending Order, taken in the House last week, adds a Greater London Council member and a balancing Ministerial appointment of a member with a good knowledge of the fisheries' interests. The Thames Conservancy, in a separate Order, was given control in the London excluded area of abstraction from underground strata.
The general effect of the Order now before the House on the constitution of the Catchment Board is very similar to what was done with the Thames Conservancy. The new constitution will be closely comparable with that of a river authority, though without the fisheries functions that river authorities will inherit from the dying river boards.
In contrast with almost all the river boards, the effect is to increase the number of members on the Catchment Board. This is the result of altering the constitution so as to provide for members from the backgrounds listed in Section 6(3) of the Act which are not already represented—industry, agriculture and fisheries. The Lee Conservancy Catchment Board, unlike river boards, already has representatives of public water supply, in the shape of members nominated by the Metropolitan Water Board.
At present, there are 21 members, of whom only one is appointed by the Minister and 20 by local authorities of one class or another, including two by the

Metropolitan Water Board. Under the Order, the overall size will be increased to 25, of whom 13 will be appointed by the councils of counties, London Boroughs, Luton County Borough and Greater London. The other 12 are to be appointed by Ministers.
We are quite satisfied that it is right to model the proposed constitution on those for the river authorities. The Catchment Board is being given extensive new powers for the management and control of water resources. The Lee catchment occupies an important place in the future development of water supplies in south-east England. This is an area where population increase and industrial expansion are bound to continue, for some time at least. London itself will continue to rely on the River Lee for one-sixth or so of its supplies.
All this must be brought about with full regard to other interests in the river, not least the navigation. It is surely right that the authority charged with these responsibilities should be similar in shape to river authorities with corresponding responsibilities elsewhere. No doubt it is proper that local authorities should continue to be in a majority, but the size of that majority needs to be cut in order to allow the voice of those directly interested in the conservation and use of water to be effectively heard.
So far as Ministerial members are concerned, the Order differs from the present constitution in this way: land drainage membership is up from one to two; public water supply membership is up from two to four; agriculture is on for the first time, with two representatives; and industry is on for the first time, with two representatives.
Given the scale of land drainage representation in other river authority areas, two members for the Lee Catchment is appropriate and so is the allowance of two members for agriculture, bearing in mind the large horticultural interests in the Lee Valley. The total number of public water supply members is increased and, as the Metropolitan Water Board has the major interest, three of the four ministerial appointments are to be made from among its nominees. This arrangement is similar to that on the Thames Conservancy, though the numbers are, of course, different.
Before the Order was made, all the local authorities concerned, all the associations of interested bodies, as well as the Metropolitan Water Board, the British Waterways Board and, of course, the Catchment Board itself were consulted. The most important of the representations which were made concerned the place of the British Waterways Board, which is the navigation authority for the part of the Lee between Hertford and the Thames which is known as the Lee Navigation.
The difficulty about applying these arrangements to the Lee is that it is a complex mixture of artificial and natural waterways. At the same time, the Metropolitan Water Board relies heavily on the Lee for its supplies and has a long established right to take all the water in the river after given quantities have been left for navigation, and it pays the British Waterways Board a sum, at present more than £40,000 a year, in recognition of that Board's work in enlarging and maintaining the capacity of the Lee.
The M.W.B. argued that it was in a special position and that if it ever came to apply for further abstractions from the river, it should be entitled to go direct to the Lee Conservancy Catchment Board and not have to apply to the Waterways Board. Its present right to take all residual water from the river will be changed under the Water Resources Act into a licence for specified quantities. Thus, if the flow in the river is increased by any means the Metropolitain Water Board may later wish to abstract increased quantities. At present, there is no additional water in the river for anyone to apply for.
After considering the Metropolitan Water Board's representations—and I received a deputation from the Board myself—we were able to accept that it was fair that an exception should be made for it and that it should be able to apply direct to the Catchment Board. This arrangement is acceptable to the British Waterways Board and is secured by paragraph 3(1, t) of the Order.
The Metropolitan Water Board also makes payments to the Catchment Board in recognition of its care for the quality of the water in the river. The Order does not make any alteration in the

present arrangements by which payments pass between the three Boards. The Ministers and the three Boards are all agreed that during the next three years, until a charging scheme under the Act comes into effect, there will be a review of the financial arrangements between the three bodies, and, subsequent to that, provision for long term arrangements under the Water Resources Act will be made in a supplementary order.
The other representations made about the Order were all about the provisions made for membership. The Metropolitan Water Board argued that it should have the right to nominate three and not two of the four public water supply representatives to be appointed by the Minister, and we accepted that, as it takes so much more water from the Lee Valley than all the other public water undertakers, this was right.
We also agreed with the Greater London Council that it should be represented in view of its interest in regional development in the Lee Valley. This created a vacancy for an additional ministerial appointment and provided a welcome opportunity to appoint someone experienced in fisheries. But we were not able to agree with the few local authorities who objected to the proposed distribution of seats. Membership was calculated on exactly the same basis as for river authorities except for the seat for the Greater London Council which I have already mentioned. Essex, on a strictly arithmetical basis, is not entitled to a member to itself, but, comparing the counties with the county and London boroughs a fair distribution is clearly three for the counties and nine for the county boroughs. A joint appointment for Essex and Bedfordshire is not an acceptable proposition, for the two counties have nothing in common and no common boundary.
The industrial representative bodies were also dissatisfied with the proposed two members, but we have carefully compared the Lee area with the area of the river authorities, and after weighing up the importance of the various interests in the area we are satisfied that two is a reasonable number.
It is something of a relief to end by getting away from these detailed points and going back to the heart of the matter.


The Catchment Board, in its present shape, has done splendid work, as all of those of us who are Londoners have special reason to know. The duties now placed on the reconstituted Board are, if anything, more important and more complex than those which it has already. This Order is the last stage in the system of water conservation that is coming into being on 1st April, a system on which, in a very large measure, the prosperity and healthy growth of the nation depends. It only remains for me to wish the new Catchment Board and the river authorities well and to stand aside and let them get on with their work

10.18 p.m.

Mr. Graham Page: I am sure that the House is very grateful to the Joint Parliamentary Secretary for the explanation—not an easy explanation—which he has given of a very difficult Order to read. One has to have the Act alongside one to understand what the Order means. I will put the hon. Gentleman's mind at rest at once and say that I do not intend to criticise the Order in any detail, or, in fact, at all

Mr. Mellish: Or to ask questions

Mr. Page: Or even to ask questions.
As I understand it, the Order creates an authority in the form in which it was laid down in the Water Resources Act, 1963, subject to exceptions, and subject to the great difficulty which the hon.

Gentleman has had in getting the constitution of the Board right. The membership has increased, we are told, from 21 to 25. All those members come on the Board because they represent a particular interest.
The hon. Gentleman seems to have struck the right balance between those interests. But I hope that now that the Board has been formed it will not continue to be a board of individuals representing separate interests, but that it will be able to act as a board, despite its size, and get the work done, because there is a great deal to be done in carrying out the work of this new conservancy Board.
I take it from what the hon. Gentleman has told the House that he is satisfied that consultation has taken place with all the interests concerned, and that, although he has not been able to reconcile all those interests, he has struck the best balance that he can. It has obviously been a very difficult undertaking.
The 27 other river authorities in the country start to operate on 1st April, 1965. I assume that it is the intention to bring this Order into operation on the same date, 1st April 1965?

Mr. Mellish: Yes, it will come into operation on that date

Question put and agreed to.

Resolved,
That the Lee Conservancy Catchment Board (New Functions of River Authorities) Order 1965, dated 1st March 1965, a copy of which was laid before this House on 3rd March, be approved.

PUBLIC HEALTH (WITHDRAWN FOODSTUFFS)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Lawson.]

10.21 p.m.

Mr. R. W. Elliott: I raise the question of imported foodstuffs on this Adjournment debate mainly, though not only, because of an understandable and enormous concern which was felt in Newcastle in recent months when suspected corned beef was released for sale in error.
Before going into the Newcastle case, I believe that it is desirable in the public interest that the danger of typhoid outbreaks should once again be emphasised. Towards the end of the last century there were about 50,000 cases a year in this country, and many of them resulted in death. The disease at that time was caused, in the main, by insanitary conditions, by low living standards, and not least by unhealthy water.
In 1965 we are inclined to think that modern sanitary conditions, modern sanitation, and generally advanced and increased medical knowledge make such diseases past history rather than present danger. It came as an enormous shock, Therefore, when the Aberdeen typhoid outbreak hit that city, very much like a plague of days gone by, and I suggest this evening that the subsequent Newcastle scare is additional evidence of the need to avoid complacency and look to controls.
The Aberdeen outbreak was extremely serious, and the Government quite rightly set up a committee under Sir David Milne to inquire into its causes. It is now generally accepted—it can never be conclusively proved—that the outbreak was caused by the polluted water of the River Parana in far-away Argentina being used in the cooling process of tinned meat.
The River Parana has standing on it the town of Rosario, the entire sewage of which enters that river in an untreated state. The Rosario canned meat factory is probably one of the largest in the world, and it was discovered eventually

by an inspector from this country that the chlorination plant there had been broken down for no less than fourteen months.
That leads me to ask the Parliamentary Secretary whether the personnel responsible for the inspection of foreign food supply sources have been increased. It seems out of all proportion, and indeed nothing short of a major public health danger, that until recently such inspection was carried out by two officers only. When we passed the Slaughterhouses Act, in 1958, we quite rightly insisted on 100 per cent. inspection of home-killed meat. I well remember our many sittings in Committee when we attempted to ensure the introduction of the maximum amount of hygiene in our slaughterhouses and meat storage plants and facilities. We seem to have closed the home loophole while leaving the foreign one wide open.
Long before the Aberdeen case—indeed, just over 10 years ago—there was the Pickering typhoid outbreak. Warning was given about the use of non-chlorinated water in this process. Is it not time that hygienic requirements were observed by establishments which export food products to this country, and that such requirements should be set out in a clear, standard form? I know that an international standard has been set down by a sub-committee of the Food and Agriculture Organisation. It can be reasonably argued that hygiene standards in relation to food should be constant throughout the world, and that if they have to be established in food producing centres we should not bear all the cost.
It is with the importation of boneless meat that we must be most concerned. I am advised that there are 700 different types of salmonella typhi which can affect such meat. I am advised that, quite apart from the occasional typhoid outbreak, this form of imported meat causes quite a lot of what we have come to know in these days as common food poisoning. As anyone who has any knowledge of the meat trade knows, it is comparatively easy to check a carcase, as compared with a tin. As far as can be determined, quite a high standard of checking is imposed upon animals for slaughter in most countries from which we receive carcases. There is a high


standard of veterinary examination of the animal both before and after slaughter.
It is when the bones are taken from the meat and it is packed in tins or cartons of one sort or another that danger arises. It is difficult for the medical officer of health in any port to check tins of meat. I understand that an occasional tin is removed from a consignment and checked, but it is much easier to check the carcase.
I now turn to the details of the Newcastle case. On the afternoon of 18th December last year—months after the Aberdeen outbreak—a West Hartlepool shopkeeper noticed on his shelves a tin of corned beef bearing the code mark publicised by the Ministry of Health during its withdrawal operation some months before. Intensive inquiries resulted in the discovery that the tin in question had been issued from a Newcastle warehouse, from stock delivered to that warehouse on 13th June, 1964, a week after the Ministry withdrawal order had been completed. This stock had been put on one side, on Ministry instructions, and the issue of tins from it had been in error. I should like publicly to commend that shopkeeper's diligence. It resulted in a major hunt in the north of England for 900 tins of potentially dangerous food. The recovery was a difficult operation, and one which was not completely successful. I should like to suggest that this recovery should not have been necessary.
I should therefore like to put to the Parliamentary Secretary the following queries. When the strongest possible suspicion was attached to meat which had come from that temporarily ill-famed establishment in the Argentine, during that danger period when the chlorination plant was broken down, why was it not clearly marked in warehouses—in Newcastle or anywhere else—as being dangerous? Is it not deplorable that there should have been no suggestion that a chance was taken with meat which had passed through that canning factory during that danger period? Should there not be adequate powers for the immediate destruction of foodstuffs, imported or otherwise, which carry any health risk? Will the Minister look, as a matter of urgency,

at those Sections of the Food and Drugs Acts which deal with condemnation of food unfit for human consumption, with a view to their extension?
Can he inform me as to the present whereabouts of the Newcastle consignment, which was put to one side last June? The latest information which I have is that the suspect beef is possibly for re-export—according to the Newcastle Journal for 9th February, 1965. I should like to ask the Parliamentary Secretary whether he will recognise—as I am sure he does—the major interests of the trade interests in this unfortunate matter. I should like him to look at the possibility of legislation which will lead to compensation for the trade interests concerned should the meat have to be destroyed—compensation which would compare with that paid to farmers when stock is slaughtered on a farm on which there is an outbreak of foot-and-mouth disease.
I should like the Minister to appreciate the general need, which the trade quite rightly sees, for public reassurance about canned meats generally, and to recognise that the Aberdeen outbreak was very damaging to the general business of canned meat. If canned meat is prepared properly, under correct hygienic conditions, it is first-class and can do a great deal towards augmenting our already short supplies of home-killed beef. It is a highly valuable and relatively cheap method of obtaining high protein.
Finally, I have to ask the Parliamentary Secretary the all-important question. Will he make arrangements, in the public interest, to ascertain the present whereabouts of all imported corned beef in the country? Will he make security arrangements, as a matter of urgency, with regard to this corned beef, wherever stocks are at present kept?

The Parliamentary Secretary to the Ministry of Health (Mr. Charles Loughlin): I want, first, to thank the hon. Gentleman the Member for Newcastle-upon-Tyne, North (Mr. R. W. Elliott) for giving me this opportunity to deal with this serious problem. I congratulate him on choosing this subject, in the interests of his constituents, for an Adjournment debate.
Obviously, the hon. Member has brought the matter before the House with the intention of allaying the fears which have been generated in the Newcastle area. I should not like his good intentions in this respect to create precisely the opposite effect in Newcastle and the rest of the country. I can assure him that there is no complacency at all—certainly not in the Ministry—about the possibilities of distribution of contaminated meat of this kind. We keep this matter constantly under review, and I hope, in the course of the next 15 minutes, to give him some idea of what the position is.
I ought to deal pretty fully with the situation at Newcastle. It is true, as the hon. Member said, that a shopkeeper in West Hartlepool on 18th December, 1964, reported to the chief public health inspector the possession of a can of corned beef bearing a serial number similar to a series of which the withdrawal had been advised in June 1964, following the outbreak of typhoid fever in Aberdeen. I join the hon. Member in paying tribute to the vigilance of this shopkeeper and to his public spirit in raising the question with the authorities.
Immediate inquiries were put in hand, and it was ascertained that the can was part of a consignment of cartons delivered to a Newcastle-upon-Tyne warehouse in June 1964. I want the date to be quite clear in the hon. Member's mind, because the entire consignment of which this can was a part was invoiced as canned in April 1964, after the end of the period—which was 1st January, 1963 to 31st March, 1964 in respect of which withdrawal was advised. This can of corned beef and these cartons of corned beef to which the hon. Member referred were canned afterwards and they were in no way a part of the consignment which resulted in the outbreak of typhoid at Aberdeen. The consignment was therefore not subject to the Health Departments' advice about withdrawal.
Nevertheless, the distributors instructed the warehouse not to release it in case the mark of identification on the cans which was very similar to that on withdrawn cans—caused confusion. This was the reason why it was withdrawn. Unfortunately, this fact was not made sufficiently clear at the time to all those con-

cerned, and when it came to light on 18th December, 1964, that some cartons had been distributed, the similarity of the code markings caused those locally concerned to assume that suspect stock might have been accidentally released.
Acting on the very proper principle of being more rather than less cautious—and I hope that throughout the length and breadth of this country, wherever there is any danger of any kind, all people, and particularly local authority people, will err on the side of caution rather than take any risks at all—the distributors themselves, together with the Newcastle Public Health Department, immediately took steps to get the cans returned to the warehouse.
At first it was thought that only 80 cartons had been released, but by the time that 80 cartons had been recovered a precautionary check on the invoices of other firms in the area had revealed that 150 cartons had been issued, which I take it is the equivalent of the 900 tins to which the hon. Member referred. On 11th January, therefore, within 10 working days of the initial suspicion—and I think that the hon. Gentleman should recognise that and realise that there was haste—because of the widespread nature of the small deliveries involved, the Newcastle Public Health Department alerted all local authorities in the area to co-operate with them in the recovery of the cans of corned beef about which the suspicion had been aroused.
When the returned cans had been subjected to expert scrutiny, it was confirmed that none of the cans which had been issued from the warehouse bore serial numbers which indicated that they were of suspect production. In fact, they had all been cooled in chlorinated water. Nevertheless, I agree with the hon. Member that the local authorities did precisely what ought to have been done. The fact that there was the slightest suspicion meant that they were quite right in dealing with the matter in this fashion.
Quite frankly, in respect of the Newcastle incident, while we agree completely that it was the correct and best possible thing to do once suspicion had been aroused, there is no evidence at all that any of the suspect stock withdrawn in June 1964 had been released. We have


asked firms to take precautions against errors which would result in the accidental release of such stocks.
My right hon. Friend said in the House, on 8th February last, that there was no reason to suppose that the statutory and voluntary measures for controlling withdrawn foodstuffs were not working well. What I have said tonight bears that out. However, this is not to deny that there may always be the possibility of human error. No one is immune from making mistakes. No system devised to deal with an operation of the kind carried out in June, 1964. in which more than 1,300 local authorities, together with innumerable shops and institutions, were concerned, can be guaranteed to achieve 100 per cent. success. It is impossible to say that somewhere, something will not go wrong, that something will not slip through the net. But the general effectiveness of the withdrawal operation and the subsequent detention of suspect stocks seems have been quite remarkable, owing to the efficiency of public health staffs and the ready co-operation of the firms and commercial establishments involved.
The hon. Gentleman mentioned the dangers of eating imported canned meat. I agree that it is obviously easier to deal with carcase meat than meat of this kind, but do not let us get this out of proportion. We must keep the whole thing in perspective because corned beef of this kind makes a great contribution to the food of this nation. While I accept that there is always the danger of food poisoning as distinct from typhoid, the evidence suggests that most of the cases of food poisoning emanating from this quarter are the result of food handling after it has gone into the shops rather than anything else.
There are a few facts I will put before the House. Since 1955 we in this country have consumed about 600,000 tons of corned beef, enough to provide more than 3,500 million meals, a meal being a portion of about 6 oz. Over this period, a total of 550 non-fatal cases of typhoid have been attributed to the consumption of corned beef. There were no deaths at all where typhoid spread by this medium was the primary cause.
The risk, then, is about one non-fatal case of typhoid per 6½ million meals of corned beef, and even this infinitesimal

risk will have been much reduced following the introduction of extra precautions against future outbreaks. We must, therefore, get this whole matter in perspective. There is a danger, in a debate of this kind, of creating a great deal of fear in the minds of people who eat corned beef. As I say, we have taken precautions and it is worth comparing the figures I have given with the risk association with, say, crossing the road. About 65,000 people were killed and 3,400,000 injured on our roads in the period I mentioned, in the last 10 years. We must, therefore, get clear in our minds just what the dangers and risks are.
The question remaining in relation to stocks of corned beef that have been withdrawn from sale is what should be done to secure their safe disposal. The Milne Committee said that, given an acceptable method of pasteurising the suspect cans, there was no reason why they should not be so treated and then released for sale in the normal way. When the Report of the Milne Committee was published in mid-December, we wrote to the United Kingdom importers and distributors advising that their stocks should remain withdrawn from sale and asking whether they proposed to re-process the meat or dispose of it—other than by selling it to the public in its untreated form. Less than a month later we sent them details of an approved method of pasteurisation designed to render the meat absolutely safe for human consumption without impairing its quality. We are in constant touch with the trade, and we already know that some firms intend to use this method to re-process their stocks. The detailed application of this method is still under consideration. Another firm is shipping its stocks back to South America for reprocessing and distribution locally.
I must emphasise however, that the final decision on the future of these stocks is one for the firms themselves to make; our duty is to safeguard the public health by seeing to it that none of the suspect meat is released for sale without further treatment. I am satisfied that our arrangements to this end are working well with the full support of all those concerned.
I could not think in terms of giving the same form of compensation to the traders in canned meat that we give to


our own farmers, but to go into that argument now would not allow me time to answer some of the questions the hon. Gentleman has asked.
The hon. Member has asked about compensation for condemned food. This does not arise at the moment. With regard generally to food condemned as unfit for human consumption, however, normally one would expect contracts at various stages of the trade to include warranties as to the fitness of the goods handled. Thus the trader holding the condemned goods would look to his supplier for redress, and if the goods were unfit before they reached him, he in turn, would look to his supplier.
The importation of any meat or meat product is prohibited unless the Government authorities of the exporting country have attached to it an official certificate attesting satisfactory ante-and post-mortem inspection of the animals, and adequate conditions of hygiene at all stages of production. Such certificates must be formally recognised before trade can begin. The administration of the official certificate procedure is a matter for my right hon. Friend the Minister of Agriculture. To avoid any possible doubt, our comprehensive and detailed hygienic requirements were notified last autumn to all exporting countries whose certificates had been recognised. Those requirements were actually spelled out in the way asked for by the hon. Gentleman.
British inspectors visit overseas establishments in the first instance to explain our hygienic requirements, and thereafter there is a regular check on the standards of inspection and hygiene practised in the country of origin. The Milne Committee recommended that the Inspectorate should be augmented; this was, in fact, done before the Committee reported. We now have four inspectors, and while that may not seem many, we think that four are adequate to deal with the particular countries from which we import these foodstuffs.
Under the Imported Food Regulations, the port medical officer has powers to examine and take samples of any food, including canned food, admitted to this country through the port for which he is responsible. Any food found unfit is not allowed to proceed for human consumption. When there is evidence of a specific

hazard from imported food, the Government take it up with the Government of the exporting country and, if necessary, arrange for appropriate action here, such as intensive sampling at the ports.
Once food intended for human consumption enters the distribution chain within the country, further samples can at any time, under the powers contained in the Food and Drugs Acts, be taken by any authorised officer of a local authority, and if he thinks that the food is unfit, he may seize it and take it before a justice of the peace, who has power to order the destruction or disposal of condemned food under the supervision of the medical officer of health. These powers are freely used.
In addition, public health officers, in co-operation with food traders, regularly secure the voluntary removal from the market of any foodstuffs which might carry health risks, without the formal exercise of statutory powers. This sort of daily co-operation, freely given, is, I am sure, the right way to ensure a healthy food supply.
Ministers do not have powers, over and above those exercised by local authorities under the Food and Drugs Acts, to condemn food or require it to be withdrawn, but past history has shown that when they have had evidence which warranted advising the withdrawal of suspect food, firms have co-operated voluntarily, as at the time of the Aberdeen outbreak. The law places on the trade the responsibility for ensuring the safety and good quality of the food it sells, and traders have never up to the present shown themselves unwilling to shoulder their responsibilities, even in circumstances where the disadvantages and difficulties to them are obvious, so long as the facts are clearly placed before them.
Obviously, I cannot deal with all the questions which the hon. Gentleman asked me, but I thing that in the general statement that I have made he will see that every precaution is taken by my Ministry and by the local authorities. There is a very high degree of co-operation with every section of the trade, whether wholesale or retail, and we are really satisfied that with the improvement of the inspectorate overseas and with the spelling out of the requirements to the exporting countries and Governments, we have gone


as far as is humanly possible in order to safeguard the health of the people of this country

The Question having been proposed after Ten o'clock and the debate having

continued for half an hour, Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at nine minutes to Eleven o'clock.